TRANSPORT OF HEMODYNAMICALLY UNSTABLE PATIENTS BY A MOBILE MECHANICALCIRCULATORY SUPPORT TEAM

Advances in medical technology have made it possible to use emergency femoro-femoral bypass (FFB) for transport of hemodynamically unstable patients. In this study, we report on our experience of transport of p atients with refractory heart failure by a special mobile mechanical c irculatory support team (MMCST) using an intraaortic balloon pump (IAB P) or FFB. A total of 22 patients (14 men, 8 women) were supported by the MMCST and transported to our clinic for further diagnostic or ther apeutic procedures. The diagnoses in 12 patients was acute myocardial infarction, in 7 patients, dilatative cardiomyopathy (DCM), and in 3 p atients, acute fulminant myocarditis. In 15 cases, FFB was implanted ( 5 in combination with IABP), and in 5 cases, IABP only was implanted. Two patients received maximal dosages of catecholamines. After arrival at our clinic, 11 patients received implants of a more sophisticated support system. From the myocardial infarction group, 3 patients recei ved coronary artery bypass grafting, 1 patient received percutaneous t ransluminal coronary angioplasty, and 1 patient received heart transpl antation as final therapy. In the myocarditis and DCM groups, 7 patien ts underwent heart transplantation. Finally, 11 patients (50%) survive d, and 11 patients died of multiorgan failure or septicemia.