Usefulness of postoperative percutaneous cardiopulmonary support using a centrifugal pump: retrospective analysis of complications.
Between January 1992 and December 1997, we employed percutaneous cardiopulmonary support (PCPS) using a centrifugal pump in 25 patients. In 21 of them, PCPS was used postcardiotomy. These patients could not be weaned from cardiopulmonary bypass due to profound ventricular failure. As for the other 4 patients, PCPS was used preoperatively for profound cardiogenic shock, a thrombosed valve, a stuck valve, and pulmonary embolization. Nine patients (43%) were weaned from PCPS (Group 1), and 3 (14%) were discharged from the hospital. The other 12 patients (57%) had perioperative extensive myocardial infarction and could not be weaned (Group 2). The causes of death were bleeding and multiple organ failure (MOF) associated with ventricular failure. The reasons for MOF were perioperative massive transfusion and hepatic congestion caused by sustained ventricular failure. To increase the survival rate, complete hemostasis and prevention of increased central venous pressure by early use of PCPS are necessary.
Yamashita
C
C
Department of Surgery, Kobe University School of Medicine, Japan. chojiro@med.kobe-u.ac.jp
Ataka
K
K
Azami
T
T
Nakagiri
K
K
Wakiyama
H
H
Okada
M
M
D058186:Acute Kidney Injury / Q000209:etiology; D000328:Adult; D000368:Aged; D001243:Assisted Circulation / Q000009:adverse effects*; D006348:Cardiac Surgical Procedures; D002315:Cardiopulmonary Bypass; D005260:Female; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D007423:Intra-Aortic Balloon Pumping; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000209:etiology; D011182:Postoperative Care; D011183:Postoperative Complications / Q000628:therapy; D012121:Respiration, Artificial; D012189:Retrospective Studies