RESULTS OF MECHANICAL VENTRICULAR ASSISTANCE FOR THE TREATMENT OF POST CARDIOTOMY CARDIOGENIC-SHOCK

The voluntary submission of data on patients who receive mechanical ci rculatory assistance for post cardiotomy cardiogenic shock and acute m yocardial infarction has resulted in an established data base for the ongoing evaluation of these devices. Since its inception in 1985, ther e have been 1,279 cases reported of implanted ventricular assist devic es for post cardiotomy cardiogenic shock. The average duration of supp ort for these devices is approximately 4 days. Those patients who unde rwent implantation of a centrifugal pump had significantly shorter per iods of support when compared with the pneumatically supported group. Patients had similar periods of support when comparing clinical outcom e. Approximately 70% of the reported cases underwent centrifugal assis tance. The majority of reported cases were supported with isolated lef t ventricular assistance. There was no significant difference in overa ll outcome statistics when comparing type or mode of support. Approxim ately 45% of reported patients were weaned from circulatory assistance , and 25% of all patients survived to discharge. These numbers remain consistent with previously reported statistics. The results with acute myocardial infarction remain limited. Of the 96 reported patients, 26 % were weaned from support and only 11.5% survived to discharge. This report continues to support the use and research for advancement of th ese devices toward the treatment of post cardiotomy cardiogenic shock.