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Cardiac Support Device: Novel Surgical Option for Heart Failure

Department of Cardiovascular Surgery 1 Department of Anesthesia and Intensive Care Medicine 2 Department of Radiology University Hospital Charité, Humboldt University Berlin Berlin, Germany 3 Department of Internal Medicine Unfall-Krankenhaus Berlin Berlin, Germany
For reprint information contact: Wolfgang Konertz, MD Tel: 49 30 4505 22092 Fax: 49 30 4505 22921 email: wolfgang.konertz{at}charite.de Department of Cardiovascular Surgery, University Hospital Charité, Humboldt University Berlin, Schumannstrae 20/21, Berlin D-10098, Germany.

From April 1999 to July 2000, the Acorn cardiac support device was assessed in 22 patients with advanced heart failure, 10 of whom received mitral valve repair. There was 1 hospital death unrelated to the device, and 2 late deaths at 2 and 8 months postoperatively. The survivors had no device-related complications during a mean follow-up of 10.4 months. Mitral valve regurgitation improved in all patients and none had evidence of constrictive or restrictive physiology on repeat cardiac catheterization at 6 months. Preoperatively, 22% were in New York Heart Association functional class II, 71% in class III, and 7% in class IV. At 6 months postoperatively, 33% were in class I, 56% in class II, 11% in class III, and none in class IV. Ejection fraction increased from 19% ± 8% to 26% ± 10% at 3 months and 24% ± 11% at 6 months. Left ventricular end-diastolic diameter decreased from 74 ± 6.1 mm preoperatively to 68 ± 11 mm at 6 months. These findings indicate that the device is safe and effective in treating heart failure. Additional studies and longer follow-up are needed to confirm these results.