Norman J C, Dacso C C, Reul G J, Massin E K, Klima T, Kahan B D, Keiser J T, Cooley D A
Artif Organs. 1978 Nov;2(4):413-20. doi: 10.1111/j.1525-1594.1978.tb01632.x.
The abdominal left ventricular assist device (ALVAD) is an order of magnitude more effective than conventional intra-aortic balloon pumping (IABP) in unloading and providing circulatory support to the failing left ventricle. This is a report of a unique case which demonstrates that in the absence of pulmonary vascular obstruction or constriction, the ALVAD can substitute for both left and right heart function. A 21-year-old patient with a congenital bicuspid aortic valve developed acute valvular endocarditis which rapidly progressed to congestive heart failure. An operation was undertaken, the mitral and aortic valves were excised and replaced by porcine heterografts, and a fistula from the right sinus of Valsalva to the right ventricle was closed. When coronary circulation was restored, irreversible ischemic contracture of the left ventricle, or "stone heart" syndrome, developed and emergency ALVAD or partial artificial heart implantation was effected. This device functioned as a total artificial heart for nearly six days, while a donor heart was sought. The patient then underwent removal of the ALVAD and cardiac and renal allografting. The transplanted heart functioned well, but the patient expired fifteen days later from gram-negative sepsis.
腹部左心室辅助装置（ALVAD）在减轻衰竭左心室的负荷并提供循环支持方面比传统的主动脉内球囊反搏（IABP）有效一个数量级。本文报告了一个独特病例，该病例表明，在没有肺血管阻塞或狭窄的情况下，ALVAD可替代左心和右心功能。一名21岁先天性二叶主动脉瓣患者发生急性瓣膜性心内膜炎，并迅速进展为充血性心力衰竭。患者接受了手术，切除二尖瓣和主动脉瓣并用猪异种移植物置换，并闭合了从主动脉瓣窦右窦至右心室的瘘管。恢复冠状动脉循环时，发生了左心室不可逆性缺血性挛缩，即“石心”综合征，并实施了紧急ALVAD植入或部分人工心脏植入。该装置作为全人工心脏运行了近六天，同时寻找供体心脏。然后患者接受了ALVAD移除及心脏和肾脏同种异体移植。移植心脏功能良好，但患者在15天后因革兰氏阴性菌败血症死亡。
