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Assisted circulation in cardiac surgery

In patients with cardiogenic shock following cardiopulmonary bypass, not responsive to intraortic balloon pump and drugs, the centrifugal pumps are the first option in many centers. These centers that use modern vortex pumps cite their simplicity, availability, relatively low cost, and low amount of blood trauma. The aim of this study is to describe the experience of InCór with 8 patients submitted to assisted circulation with biopump from May 1990 to December 1991 . Intraortic balloon counterpulsation was used in these 8 patients with conventional medical therapy. Their ages ranged from 54 to 66 . Three patients were submitted to coronary bypass, 2 to mitral valve replacement, 2 to left ventricular aneurysm correction and 1 to heart transplantation. Left atrial to aortic bypass was done in 7 patients and in 1 , right atrial to pulmonary bypass. The patients were assisted from 18 to 12 6 hours. Three patients died during assisted circulation: 2 were in bridge to transplantation and didn't achieve donor organ, and 1 died due to bleeding and acute renal failure. Five (62.5%) patients were weaned from the device, but 2 died at hospital, 1 due to respiratory failure and 1 due to neurologic and renal failure. When we compared the clinical evaluation with CKMB, we noted that 3 patients with CKMB greater than 80 died, 2 during assisted circulation. In 5 patients with CKMB less than 80 , 4 were weaned from the device and 3 were discharged from the hospital. Two patients discharged from the hospital are in NYHA functional class II and 1 in class I. The early utilization of assisted circulation will lead to better results in this group of high risk patients.

biopump; biopump; assisted circulation


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