Transport of hemodynamically unstable patients by a mobile mechanical circulatory support team.
Advances in medical technology have made it possible to use emergency femoro-femoral bypass (FFB) for transport of hemodynamically unstable patients. In this study, we report on our experience of transport of patients with refractory heart failure by a special mobile mechanical circulatory support team (MMCST) using an intraaortic balloon pump (IABP) or FFB. A total of 22 patients (14 men, 8 women) were supported by the MMCST and transported to our clinic for further diagnostic or therapeutic procedures. The diagnoses in 12 patients was acute myocardial infarction, in 7 patients, dilatative cardiomyopathy (DCM), and in 3 patients, acute fulminant myocarditis. In 15 cases, FFB was implanted (5 in combination with IABP), and in 5 cases, IABP only was implanted. Two patients received maximal dosages of catecholamines. After arrival at our clinic, 11 patients received implants of a more sophisticated support system. From the myocardial infarction group, 3 patients received coronary artery bypass grafting, 1 patient received percutaneous transluminal coronary angioplasty, and 1 patient received heart transplantation as final therapy. In the myocarditis and DCM groups, 7 patients underwent heart transplantation. Finally, 11 patients (50%) survived, and 11 patients died of multiorgan failure or septicemia.
Reiss
N
N
Clinic for Thoracic and Cardiovascular Surgery, Ruhr University of Bochum, Bad Oeynhausen, Germany.
el-Banayosy
A
A
Posival
H
H
Knobl
H
H
Minami
K
K
Körfer
R
R
D000328:Adult; D000552:Ambulances / Q000592:standards; D002311:Cardiomyopathy, Dilated / Q000401:mortality / Q000628:therapy; D002315:Cardiopulmonary Bypass; D005260:Female; D006333:Heart Failure / Q000401:mortality / Q000503:physiopathology*; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D007362:Intensive Care Units; D007423:Intra-Aortic Balloon Pumping; D008021:Life Support Systems / Q000592:standards*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality / Q000628:therapy; D009205:Myocarditis / Q000401:mortality / Q000628:therapy; D014187:Transportation of Patients / Q000592:standards*