Experience with emergency cardiac surgery following institution of percutaneous cardiopulmonary support

Between August 1992 and February 1998, 43 patients were treated with percut aneous cardiopulmonary support (PCPS) in our institution, and 8 of them sub sequently required emergency cardiac surgery. There were 3 males and 5 fema les with a mean age of 63 years (range, 37 to 81 years). The etiology of sh ock in these 8 patients was acute myocardial infarction in 3, postinfarctio n left ventricular (LV) free wall rupture in 1, postinfarction ventricular septal perforation (VSP) in 1, LV free wall rupture and VSP in 1, and fatal arrhythmia due to severe aortic valvular disease in 2. The mean time inter val from the onset of cardiogenic shock to the institution of PCPS was 77 m in (range, 18 to 183 min). The mean time interval from the institution of P CPS until surgery was 145 min (range, 40 to 603 min). The surgical procedur es were coronary artery bypass grafting (CABG) in 3 patients, closure of th e LV rupture and/or closure of VSP in 3, and aortic valve replacement in 2. Six patients were weaned from PCPS, and 2 patients were discharged from th e hospital (discharge rate, 25%). Although the results of emergency cardiac surgery following PCPS still are not satisfactory, we continue to apply PC PS and perform appropriate surgical procedures to improve the survival rate of the patients who would die without PCPS.