title: Clinical experience of assisted circulation with a centrifugal pump at Tokyo Women's Medical College.
abstract: In postpericardiotomy patients, the use of pulsatile pumps is limited in a semielective fashion to patients whose postoperative marginal hemodynamics are expected preoperatively. Since 1989, 25 patients have undergone assisted circulation with a centrifugal pump: 15 (60%) were weaned from the pump, and 7 (28%) survived. In 1988, we heparin-coated the Bio-Pump using the Carmeda technique and developed a totally heparin-coated left heart bypass system together with heparin-coated cannulas and tubing. Four postpericardiotomy patients underwent left heart bypass with this system without heparin for 2 to 9 days. No thrombus was detected in the system. Left heart bypass with a centrifugal pump has been used as a supportive method in surgical repair of thoracic or thoracoabdominal aortic aneurysm. To overcome intraoperative hypothermia and hypoxia, we used a small membrane oxygenator with a heat exchanger in 11 patients, and postoperative recovery dramatically improved. We also developed a preassembled percutaneous cardiopulmonary support (PCPS) system with an automatic priming function using Terumo's straight path centrifugal pump and small membrane oxygenator in cooperation with the Terumo Corporation. This system was used in a patient with cardiogenic shock after acute myocardial infarction. The setup and priming took only 5 min, and 2.5-3.5 L/min of flow was obtained.
authors.affiliation: Department of Cardiovascular Surgery, Tokyo Women's Medical College, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Nishida
authors.forename: H
authors.initials: H
authors.lastname: Koyanagi
authors.forename: A
authors.initials: A
authors.lastname: Hashimoto
authors.forename: M
authors.initials: M
authors.lastname: Endo
authors.forename: S
authors.initials: S
authors.lastname: Aomi
authors.forename: T
authors.initials: T
authors.lastname: Koyanagi
authors.forename: J
authors.initials: J
authors.lastname: Hirota
authors.forename: O
authors.initials: O
authors.lastname: Tagusari
authors.forename: F
authors.initials: F
authors.lastname: Yamaki
mesh_terms: D000328:Adult; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D006348:Cardiac Surgical Procedures; D004867:Equipment Design; D005260:Female; D016027:Heart Transplantation; D006353:Heart-Assist Devices; D006493:Heparin; D006801:Humans; D008297:Male; D008875:Middle Aged; D010107:Oxygenators, Membrane; D011183:Postoperative Complications / Q000628:therapy*; D012770:Shock, Cardiogenic / Q000628:therapy; D013927:Thrombosis / Q000517:prevention & control
chemical_list: D006493:Heparin