MECHANICAL VENTRICULAR SUPPORT USING PULSATILE ABIOMED BVS-5000 AND CENTRIFUGAL BIOMEDICUS-PUMP IN POSTCARDIOTOMY SHOCK

Since we started using ventricular assist devices (VAD) in July 1987 u p to August 1993, 63 of 15,650 (0.4%) patients (pts) who underwent ope n heart sugery were supported postoperatively by VAD at out institutio n. Forty-three were male and 20 female, mean age 55.5 years. In 49 pts coronary artery bypass grafting (CABG), in 8 pts valve surgery, in 3 pts combined CABG and valve surgery and in 3 pts corrective procedures for congenital heart disease were performed. Perioperative myocardial infarction was the most frequent indication (73%). In 37 of the 63 pt s (58.7%) a centrifugal (Biomedicus pump (group A) was used and in 26 pts (41.3%) a pulsatile Abiomed BVS 5000 (group B). Fourteen of 37 pts (38%) in group A were weaned from the VAD and all of them were discha rged. Twenty-three pts were unable to be weaned and 19 of these pts di ed. The remaining 4 pts were transplanted successfully and subsequentl y 3 died and I was discharged. In all, 15 pts (39%) were long-term sur vivors. Sixteen of 26 pts (62%) in group B were weaned from VAD and 13 (50%) of them were discharged of whom 3 died. Ten patients were unabl e to be weaned and 7 of these died. The remaining 3 pts were transplan ted successfully. In all, 16 pts (61.5%) were long-term survivors. The shorter the interval between beginning resuscitation and application of VAD the better the outcome. Younger age, VAD installation in OR, su pport time between 2 and 7 days and Abiomed pump, influence the surviv al rate positively. Because of higher recovery and survival rates in p atients assisted by Abiomed compared to the Biomedicus pump, we recomm end the Abiomed pump in postcardiotomy cardiac failure.