Haemodynamic changes in patients undergoing high-risk PTCA under protection of transfemoral heart- lung machine support with centrifugal pumps.
Patients with a high risk for myocardial revascularization by cardiological or surgical means can be supported during high-risk PTCA with mechanical circulatory support (supp HR-PTCA). Between November 1994 and June 1997 we performed 28 supp HR-PTCA's under protection of a heart-lung machine (HLM) with femoro - femoral cannulation under regional anesthesia. We approached 2.8+/-1.5 stenoses and 1.7+/-0.6 vessels per patient. Primary success rate was 95 percent of the treated vessels. During unloading, pulmonary artery mean pressure fell to 42+/-29% of the starting value, and LVEDP was decreased to 36+/-42%. Mechanical unloading also resulted in a significant reduction of left ventricular volumes (unloaded LVEDVI and LVESVI represent 76.8% and 76.6% of pre-unloaded values, respectively, p<0.05). All patients except one survived the procedure and could be discharged from the hospital. Femoro-femoral cardio-pulmonary bypass under regional anesthesia provides sufficient protection for high risk PTCA procedures and enables high risk patients to benefit from coronary revascularization.
Waldenberger
F R
FR
Department of Cardiac Surgery, University Hospital Charité, Humboldt University at Berlin, Germany. waf@1ch.khl.magwien.gv.at
Borges
A
A
Schubel
J
J
Baumann
G
G
Konertz
W
W
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D015906:Angioplasty, Balloon, Coronary; D002315:Cardiopulmonary Bypass / Q000295:instrumentation*; D003327:Coronary Disease / Q000628:therapy*; D005260:Female; D005268:Femoral Vein; D006355:Heart-Lung Machine; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged