Analysis of the cases who showed difficulty in weaning off fran extracorporeal circulation

Abstract

Despite great advances in cardiac surgery and techniques in extracorporeal circulation in recent years, there are still few cases showing difficulties in weaning off from extracorporeal circulation. Intraaortic baloon pumping (IABP) and/or left heart bypass (LHB) should be indicated for these cases.
We have analyzed the modes of weaning off from extracorporeal circulation in 248 cases who underwent open heart surgery using extracorporeal circulation in the period between 1976 and 1978 in our institute.
Mean time from canpletion of intracardiac repair and termination of extracorporeal circulation in all cases was 34 minutes, but that of the cases who did not require any cardiotonic drugs and/or antiarrhythmic drugs was 24 minutes. Of 248 cases, 65 cases (24.5%) required cathecholamines and 36 cases (13.4%) required antiarrhythmic drugs. 37 cases (14%) required more than 40 minutes of extracorporeal circulation after canpletion of intracardiac repair and all of them required cathecholamines and/or antiarrhythmic drugs. Moreover, of 37 cases 6 cases (2.3%) could not be weaned off from extracorporeal circulation. In 31 cases who could be weaned off from prolonged extracorporeal circulation, IABP was utilized in 2 cases and LHB in one case for the relief of severe left heart failure with excellent results.