PERCUTANEOUS CARDIOPULMONARY SUPPORT AS A BRIDGE TO OPERATION IN PATIENTS WITH SERIOUS ISCHEMIC HEART DISEASE

Abstract

The use of percutaneous cardiopulmonary support (PCPS) has been facilitated as an adjuvant procedure for severe heart failure or pulmonary insufficiency. In this study, four patients with serious ischemic heart disease who were applied PCPS as a bridge to operation at the department of internal medicine in our hospital were investigated.
PCPS flow was kept at 0.5 to 1.5L/min preoperatively that contributed to improve their hemodynamics. PCPS was performed uneventfully for 2 hours to 3 days. Three patients were intubated and placed on mechanical ventilation. Intraaortic ballon pumping (IABP) was combined with PCPS in three patients. Two patients who did not require postoperative PCPS survived operation. But the remaining two patients with extensive myocardial damage needed PCPS combined with IABP postoperatively. They could not be weaned from these supports and died on the 6th and 9th postoperative day, respectively. In these two patients, the most determinant factor of their deaths might lie in the severity of the original diseases, but the long-term use of PCPS after thoracotomy might worsen ischemia in the lower extremities, bleeding, DIC, and multiple organ failure.