1. Management of postcardiotomy cardiogenic shock with a new pulsatile ventricular assist device. Initial clinical results.
- Author
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Kaan GL, Noyez L, Vincent JG, van de Wal H, Skotnicki SH, and Lacquet LK
- Subjects
- Coronary Artery Bypass, Equipment Design, Extracorporeal Circulation, Female, Humans, Male, Middle Aged, Postoperative Complications mortality, Pulsatile Flow, Shock, Cardiogenic mortality, Survival Rate, Time Factors, Heart-Assist Devices, Postoperative Complications therapy, Shock, Cardiogenic therapy
- Abstract
The authors began ventricular assist pumping as treatment for postcardiotomy cardiogenic shock in November 1988 with a new automated pulsatile support system, the ABIOMED BVS 5000 Bi-Ventricular Support System. Five patients (0.6% of total cardiac surgery patients) have been placed on support, four after coronary artery bypass grafting, and one after bypass grafting and mitral valve repair. All patients were refractory to pharmacologic and intraaortic balloon pump therapy. Three patients had left ventricular support and two had biventricular support. Four patients were successfully weaned, and three are long-term survivors. Duration of support ranged from 39 to 118 hours (mean, 89.4 hours). Resternotomy was performed in four patients: twice for hemostasis, once for tamponade, and once for inadequate left ventricular drainage. Three patients, two nonsurvivors and one survivor, had perioperative myocardial infarctions. No device related thromboembolic complications, hemolysis, or infection were experienced. Follow-up at more than 1 year demonstrated that all patients are in NYHA Class 1. Ventricular assist pumping with the ABIOMED BVS 5000 Bi-Ventricular Support System is an effective treatment for postcardiotomy cardiogenic shock.
- Published
- 1991