five patients with one- or two-vessel disease had one to three bypass
grafts using the Hemopump cardiac assist system instead of cardiopulmo
nary bypass to decompress the heart and as circulatory support. In add
ition, the short-acting beta-blocker esmolol was given as a bolus and
stepwise titrated to make the heart flaccid and facilitate operation.
All patients had a 24F Hemopump placed into the left ventricle. The pa
tients were given 7,500 U of heparin. Average time on Hemopump support
was 56 minutes. All patients went through the procedure uneventfully.
Thirty minutes after pump removal all patients were back to baseline
hemodynamic values. None of the patients needed blood transfusion. No
postoperative renal impairment was seen. This method has great potenti
al and could avoid the drawbacks associated with cardiopulmonary bypas
s and cardioplegic arrest. Careful evaluation in randomized studies is
the next step.