Clinical evaluation of centrifugal pump in left heart bypass for patients with postcardiotomy shock

Abstract

Clinical experience with the use of the centrifugal pump for left heart bypass was reviewed in patients with postcardiotomy shock in an attempt to improve survival. Twenty-one patients who could not be weaned from cardiopulmonary bypass were reviewed. All patients with postcardiotomy heart failure were supported with a centrifugal pump as left heart bypass. The mean duration of support was 102±66 h. Nine patients (43%) needed right heart bypass through the same median sternotomy because of right heart failure. The weaning rate was 67% and the survival rate was 43%. Twelve patients died. Seven patients were not weaned from the device and died of multiple organ failure, including major bleeding in five patients. The other five patients were weaned from the device but died of low cardiac output syndrome (three patients), infection (one patient), and brain death (one patient). The complications related to the device included bleeding in seven patients (33%), of which only one patients survived. Four patients had stroke (19%), and two of them survived. These data demonstrated that postoperative bleeding and stroke were the major factors affecting survival in patients with postcardiotomy heart failure with a centrifugal pump used as left heart bypass.