MECHANICAL CIRCULATORY SUPPORT - THE BAD OEYNHAUSEN EXPERIENCE

From September 1987 to February 1994, we treated 147 patients ranging between 11 and 82 years old with different mechanical circulatory supp ort systems. The applied devices were the Bio-Medicus centrifugal pump in 61 patients, the Abiomed BVS System 5000 in 49 patients, the Thora tec ventricular assist device in 42 patients, and the Novacor left ven tricular assist device in 7 patients. On the basis of indication for m echanical circulatory support, the patients were divided into three gr oups: group 1 consisted of 72 patients with postcardiotomy cardiogenic shock; group 2, 50 patients in whom mechanical support was used as a bridge to cardiac transplantation; and group 3 (miscellaneous), 25 pat ients in cardiogenic shock resulting from acute myocardial infarction (n = 14), acute fulminant myocarditis (n = 3), primary graft failure ( n = 2), right heart failure after heart transplantation (n = 3), and a cute rejection (n = 3). Time of support ranged from 1 hour to 97 days (mean duration, 10.8 days). Seventy-five patients (51%) were discharge d from the hospital. The best survival rate was achieved in group 2 wi th 72%, followed by group 1 with 44% and then group 3 with 28%. The mo st frequent complications in group 1 were bleeding (44%), multiple-org an failure (24%), neurologic disorders (18%), and acute renal failure (15%). In group 2, the major complications were bleeding (34%) and cer ebrovascular disorders (22%) and in group 3, multiple-organ failure an d sepsis (60%) and bleeding (32%).