CLINICAL CONSIDERATION OF POST-CARDIOTOMY SUPPORT BY CENTRIFUGAL PUMP AS VENTRICULAR ASSIST DEVICE

Abstract

Our 8 patients' experience with centrifugal pump ventricular assist device (VAD) was analized to determine variables influencing the outcome. Biventricular bypass was performed in 2 patients, and right ventricular bypass in 2, and other 4 received left VAD. Patients were deviled into 2 groups: Group A consisted of 4 patients who were either weaned from VAD (3) or died on VAD from cerebral death (1), Group B consisted of 4 patients who were not waened from VAD. Although the mean pump flow rate was more than 3.0L/min in both groups, mean aortic pressure (m-AoP) was lower in Group B. Group B showed lower SvO₂ and higher level of VO₂I. Blood lactate level and temperature difference between central and peripheral sites were useful to assess the perfusion state. Main complications during ventricular support were bleeding which required reoperation in 5 patients, renal failure with dialysis in 5. From our experience with centrifugal pump VAD, in patients with postoperative profound shock in whom it was difficult to maintain m-AoP≥60mmHg, weaning from VAD was not possible.