Paracorporeal artificial heart in postoperative heart failure.

A pneumatically driven artificial heart with a tubular silicone rubber membrane and disc valves was used for functional heart replacement in the paracorporeal mode. A fluidic drive system allows adjustment of the heart rate, positive and negative pressures and systole/diastole ratio. Since August, 1977, the artificial heart has been used in four patients with refractory postoperative heart failure not responding to volume loading, pH and electrolyte correction, catecholamines and intra-aortic balloon pumping. Large cannulae were placed in the atria and great vessels. The ventricles were fixed on the chest paracorporeally. The assist system was used as a left heart bypass in one patient and as a biventricular bypass in three other patients. After 48-72 hours, the ventricular function recovered in three patients, permitting removal of the artificial heart. One patient died of cerebral complications six weeks later; the other two recovered completely and were released in good condition. Profound postoperative heart failure can be completely reversed by the use of the paracorporeal artificial heart; the advantage of the system lies in the simplicity of its implantation and removal.