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The Journal of Thoracic and Cardiovascular Surgery, Vol 104, 541-552, Copyright © 1992 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
WE Pae Jr, CA Miller, Y Matthews and WS Pierce
Data submitted voluntarily to the combined registry since its inception in
1985 to December 31, 1990, on the use of ventricular assist devices for
postcardiotomy cardiogenic shock in 965 patients were analyzed.
Approximately 45% of patients were weaned from temporary circulatory
assistance and 24.6% reached hospital discharge regardless of the original
operation. In 90% of patients who were discharged from the hospital,
circulatory support was able to be discontinued by 1 week. Rates of weaning
and discharge were statistically different and favored those patients
requiring univentricular support only. Results were equal whether
nonpulsatile centrifugal or pulsatile pneumatic devices were used for
support. Although complications were frequent and multiple during assist
pumping, patient variables including age greater than 70 years rather than
direct complications caused by circulatory support were likely to affect
overall outcome. In patients achieving hospital discharge, 2-year actuarial
survival was 82% with 86% of patients being in New York Heart Association
functional class I or II. In rare instances of device dependency in 43
patients (4.5%) with no contraindications to transplantation, 32 (74.4%)
underwent bridge to cardiac transplant and 20 (62.5%) were discharged. This
multi- institutional experience would continue to support the use of
ventricular assist devices in postcardiotomy cardiogenic shock.
ARTICLES
Ventricular assist devices for postcardiotomy cardiogenic shock. A combined registry experience
Department of Surgery, College of Medicine, Pennsylvania State University, Hershey 17033.
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