Acute and temporary ventricular support with BioMedicus centrifugal pump

Background. Short-term ventricular and pulmonary support can be provided by the Medtronic BioMedicus (Eden Prairie, MN) centrifugal pump, which is ava ilable in most cardiovascular surgery centers. This versatile pump can prov ide support during cardiopulmonary resuscitation, cardiopulmonary bypass, e xtracorporeal membrane oxygenation, and ventricular assistance. A common us e of the pump is to provide ventricular assistance for patients after cardi otomy or cardiogenic shock. Methods. From January 1986 to September 1995, 141 patients at The Methodist Hospital in Houston, Texas were placed on the BioMedicus centrifugal pump after postcardiotomy cardiac failure. Patient treatment and postimplant com plications are discussed. Results. Fifty-four percent of the patients were weaned; however, only 22% survived to discharge. There was a very high mortality rate in the early st age after support was discontinued, after weaning, and after device removal . Conclusions. A high incidence of complications and death is likely related to the period of attempted weaning from cardiopulmonary bypass before the i nitiation of ventricular support. When weaning a patient from the pump duri ng cardiopulmonary bypass or during ventricular assistance, it is important to optimize preload, afterload, ventricular function, and cardiac rhythm. In patients who have had postcardiotomy support, avoiding fluid overload, l ow colloid oncotic pressure, hypoperfusion, and use of excessive inotropic and vasoactive medications improve results. (C) 1999 by The Society of Thor acic Surgeons.