title: Assisted circulation in postcardiotomy heart failure: experience with the Bio-Medicus centrifugal pump in ten patients.
abstract: Between January 1990 and September 1992, ten patients required assisted circulation for postcardiotomy heart failure which was unresponsive to inotropic drugs and aortic counterpulsation. All patients were supported by a Bio-Medicus centrifugal pump (biventricular assist in five, left ventricular in three, right ventricular in two); six had ischaemic heart disease, two a congenital ventricular septal defect, one an acute mitral valve incompetence and one an aortic type 'A' dissection. The mean duration of circulatory support was 5.1 days (range 2 hours to 8 days). Six patients were weaned from the device and four were discharged; the perioperative deaths among the patients weaned from support were the result of cerebral haemorrhage and multiorgan failure respectively. No late deaths occurred at a mean follow-up of 15 months. Common complications were bleeding (40%), acute renal failure (30%) and sepsis (30%). All patients who developed renal failure died. The high incidence of haemorrhagic complications makes the use of pre-heparinized circuits desirable as these patients do not then require additional anticoagulation.
authors: Cardiovascular and Respiratory Diseases Institute, H.S. Raffaele University of Milan, Italy.
authors: G
authors: G
authors: Paolini
authors: M
authors: M
authors: Triggiani
authors: G
authors: G
authors: Di Credico
authors: M
authors: M
authors: Pocar
authors: P
authors: P
authors: Stefano
authors: E
authors: E
authors: Montorsi
authors: F
authors: F
authors: Simeone
authors: G
authors: G
authors: Paolillo
authors: A
authors: A
authors: Grossi
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology; D000368:Aged; D000784:Aortic Dissection / Q000601:surgery; D001014:Aortic Aneurysm / Q000601:surgery; D001243:Assisted Circulation / Q000009:adverse effects / Q000295:instrumentation*; D001424:Bacterial Infections; D002303:Cardiac Output, Low / Q000209:etiology / Q000628:therapy*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects; D002423:Cause of Death; D002543:Cerebral Hemorrhage / Q000209:etiology; D002675:Child, Preschool; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006345:Heart Septal Defects, Ventricular / Q000601:surgery; D006353:Heart-Assist Devices / Q000009:adverse effects; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000601:surgery; D009102:Multiple Organ Failure / Q000209:etiology; D017202:Myocardial Ischemia / Q000601:surgery; D015996:Survival Rate