Seven Years of Experience with the Centrifugal Pump in Patients with Cardiogenic Shock

Abstract

From September 1987 to September 1994 61 patients between 29 and 78 years of age received mechanical circulatory support by means of the Biomedicus centrifugal pump. The patients were divided into three groups by indication: Group I included 15 patients with early postcardiotomy cardiogenic shock and 24 patients with late postcardiotomy cardiogenic shock. Group II 11 patients with therapy-resistant cardiogenic shock following acute myocardial infarction, and Group III 11 patients with cardiogenic shock of other etiologies. Duration of support was 1 to 347 hours. Survival rates were 46.7% and 33.3% in patients with early and late postcardiotomy cardiogenic shock, respectively (Group I), 27.2% in Group II, and 18.1% in Group III. Most frequent complications were bleeding (40%, 58%) and acute renal failure (26.7%, 29.2%) in Group I and multiple organ failure in Groups II and III (64% and 45.5%). Major causes of death were bleeding and multiple organ failure in Group I (37.5%) and multiple organ failure in Groups II and III (87.5% and 50%). Groups II and III (87.5% and 50%).

Regional Referral System for Patients with Acute Mechanical Support: Experience at The Cleveland Clinic Foundation

“…16,17 Similarly, in a report from Germany, MSOF was the major cause of death in postcardiotomy shock patients with mechanical cardiac support. 18 Just one organ system can reduce survival significantly for this patient population. For instance, in the group of patients reported by McBride et al, 100% mortality was observed for those patients who had at least one organ failure in addition to the cardiovascular system.…”

Cardiac retransplantation

“…Therefore, the Bio-Medicus ® Centrifugal Pump and Abiomed ® device are only applied for short-term support where recovery is expected. In cases where severe cardiac damages become obvious and longterm support is indicated, the Thoratec ® , Novacor ® (Novacor Corp, Oakland, CA, USA), or HeartMate ® (Thermo Cardiosystems, Woburn, MA, USA) devices are preferred where applicable [83][84][85]88,[192][193][194][195]197,240,242,295,348,349]. In keeping with the literatures [220,230,330], however, implanting a VAD in patients having early cardiac allograft failure in order to bridge them to Re-CTx as quickly as possible has produced very disappointing results in the present study.…”