Abstract
In this paper, we presented our experience of as sisted circulation (percutaneous cardio-pulmonary support: PCPS, ventricular assist system: VAS) in critical care for acute profound heart failure including our compact integrated eardiopulmonary bypass unit (CIGU) and NCVC type VAS. We performed PCPS in 56 acute profound heart failures and VAS in 12 including acute deterioration of chronic profound heart failure from 1990. In PCPS cases, 7 weaned cases and 3 other cases, wha were switched to other procedures, were survived. In VAS cases, all three cased died without cardiac recovery under VAS management focused on cardiac recovery. In recent cases under VAS management focused on recovery of general condition, three acute profound heart failure cases and two acute deterioration cases showed heart recovery and two of them discharged (one case is on-going). In critical care for acute profound heart failure, acute worsening of hemodynamics and profound cardiac damage were serious problems. In acute worsening of hemodynamics, POPS is useful to maintain total circulation by quick application and our CICU is well matched to this purpose. In profoundly damaged heart cases, several cases may show cardiac recovery after prolonged VAS support. However, application of wearable LVAS or heart transplantation is needed in poor recGvery cases.
