[Mechanical methods of treating XXXX ].

@entity1 @entity712 @entity120 @entity1003 @entity299 @entity1455
Mechanical means tend to be used more frequently nowadays for the treatment of @entity712 which does not respond to more normal treatment. The indications and limits of such devices, as well as their cost, must be defined. The new problem created by these therapeutic tools is the evolution of the underlying @entity299 : should it improve the @entity1 will be weaned from the machine, whereas if it worsens heart transplantation would be the only answer. Three types of mechanical support are described. Balloon pumping, and especially intra-aortic balloon pumping, is the technique used most often. It has a true but limited efficacy. Its best indication is @entity1455 by left ventricular ischaemia with normal or slightly increased peripheral resistances. Intrapulmonary balloon pumping is occasionally used, but the system can only be set up surgically. Its best indication would seem to be right-sided @entity712 by @entity120 . Circulatory assistance is the second type considered. All types of bypass pumps can be used. The output used is usually less than the @entity1 's theoretical output, the aim being to allow the myocardium to recover. Vascular access for these pumps is either femoral or intrathoracic. An oxygenator may or may not be added to the bypass circuit, and support may be mono- or biventricular. Although the non pulsatile flow has not been shown to be detrimental, this has to be investigated further. The use of these devices is limited by their effects on @entity1003 and pulmonary function. The artificial heart or artificial ventricles are the last devices described.(ABSTRACT TRUNCATED AT 250 WORDS)
