Beneficial circulatory support by left heart bypass with a centrifugal (BioMedicus) pump for aneurysms of the descending thoracic aorta.
A comparative study between left heart bypass with a centrifugal (BioMedicus) pump and with a temporary external shunt was performed to assess the efficacy of distal organ perfusion in the surgical treatment of 31 patients with aneurysm of the descending thoracic aorta. Eighteen patients were supported with a centrifugal pump, and the remaining 13 were supported by temporary shunt with either a Gott shunt or a Dacron graft. Heparinless bypass with a centrifugal pump provided a significant decrease of intraoperative blood loss and blood transfusion by the combined application of Cell-Saver. The pressure difference between upper and lower extremities decreased (p < 0.05) in the centrifugal pump group even with aortic cross-clamping, and the urine output increased during operation. Among 13 patients supported with the temporary shunt, 3 had postoperative renal failure, and 2 died of it. All patients with a centrifugal pump survived without any complications. It could be concluded that the left heart bypass with a centrifugal (BioMedicus) pump was safe and was favorable for support of the distal circulation during aortic cross-clamping and to prevent ischemic complications such as renal failure and spinal cord injury.
Department of Surgery, Kobe University School of Medicine, Japan.
K
K
Ataka
M
M
Okada
C
C
Yamashita
K
K
Kujime
E
E
Kihana
N
N
Yoshimura
T
T
Azami
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017545:Aortic Aneurysm, Thoracic / Q000378:metabolism / Q000503:physiopathology / Q000601:surgery*; D001219:Aspartate Aminotransferases / Q000097:blood; D001794:Blood Pressure; D001806:Blood Urea Nitrogen; D002315:Cardiopulmonary Bypass; D003404:Creatinine / Q000097:blood; D005260:Female; D006353:Heart-Assist Devices; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D014556:Urine
D003404:Creatinine; D001219:Aspartate Aminotransferases