Cardiothoracic History

In 1971 Saint Louis University was one of the first five centers in the United States to initiate clinical use of an intraaortic balloon pump. Since that time intraaortic balloon pumping has become the most widely used form of mechanical circulatory support and is now considered conventional therapy for low cardiac output states. Throughout the 1970s clinicians at Saint Louis University evaluated continuous flow (nonpulsatile) systems to temporarily support the circulation of patients suffering from severe heart failure. In 1981 Saint Louis University was awarded one of four grants provided by the National Institutes of Health to evaluate pulsatile ventricular assist devices in patients with cardiogenic shock.

 

The results of this work contributed to the development, clinical application and commercialization of the Thoratec ventricular assist device (Thoratec Laboratories Corp., Berkeley, CA) (Figure 1). In 1985 Saint Louis University acquired the Jarvik total artificial heart and the Novacor implantable electrical left ventricular assist system (Figure 2). All of these devices have been used to treat end-stage heart failure refractory to medical therapy. These devices provide a "bridge" to heart transplantation, enabling the patient to survive until a donor heart is available. They can also be used to support patients until their hearts recover (patient pictured).

 

Recent developments in the design of the Novacor left ventricular assist system have made the components portable so they can be carried by an individual without difficulty. This has allowed some bridge to transplant patients to be discharged from the hospital and await location of a donor heart at home. In the near future it is hoped that further improvements in the design of the Novacor device will result in the use of this system as a permanent ventricular assist device.


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