Bio-medicus ventricular assist device for salvage of cardiac surgical patients.
Over a 5-year period, 41 (1%) of 4,193 patients undergoing cardiac operations underwent intraoperative or early postoperative insertion of a Bio-Medicus ventricular assist device when it became apparent that the patient could not otherwise survive. Fourteen patients were in cardiogenic shock and 7 were in cardiac arrest at the time of initiation of their primary cardiac surgical procedure, and in no instance was the device planned as a bridge to cardiac transplantation. Bleeding, sepsis, and thromboembolism were frequent postoperative complications. Central nervous system deficits were observed in 16 patients during their postoperative course. Eight patients (19.5%) were long-term survivors. Of the preoperative risk factors evaluated only age was significantly associated with survival, with 7 (33%) of the 21 younger (39 to 63 years) patients surviving. Blood product usage and hospital cost were analyzed in an attempt to assess cost/effectiveness of use of this device for attempted salvage of such desperately ill patients.
Killen
D A
DA
MidAmerica Heart Institute of Saint Luke's Hospital, Kansas City, Missouri.
Piehler
J M
JM
Borkon
A M
AM
Reed
W A
WA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical / Q000401:mortality; D002315:Cardiopulmonary Bypass / Q000401:mortality; D002423:Cause of Death; D003327:Coronary Disease / Q000150:complications; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D006323:Heart Arrest / Q000401:mortality / Q000628:therapy*; D006353:Heart-Assist Devices; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000628:therapy*; D012770:Shock, Cardiogenic / Q000401:mortality / Q000628:therapy*