MECHANICAL CIRCULATORY SUPPORT WITH THE THORATEC ASSIST DEVICE IN PATIENTS WITH POSTCARDIOTOMY CARDIOGENIC-SHOCK

Background. In spite of modern cardiac surgical techniques, severe car diogenic shock not responding to pharmacologic therapy and intraaortic balloon pumping develops in about 0.2% to 1.2% of patients undergoing cardiac operations. Methods. From September 1987 to September 1994, 1 84 patients were supported with different mechanical circulatory suppo rt systems. Nine patients with postcardiotomy cardiogenic shock were s upported with the Thoratec ventricular assist device. Four patients su ffered early postcardiotomy cardiogenic shock, and 5 patients suffered late postcardiotomy cardiogenic shock. In 6 patients the Thoratec dev ice was applied exclusively, in 2 patients both Bio-Medicus and Thorat ec, and in 1 patient both ABIOMED and Thoratec devices were used. Dura tion of support ranged from 5 to 46 days with a mean duration of 15 da ys. Results. Four patients (44%) survived and were discharged. Main co mplications and causes of death were multiple organ failure and sepsis . Conclusions. The results justify the use of Thoratec assist device i n patients with severe preoperative cardiogenic shock.