Centrifugal pumps: Description of devices and surgical techniques

Background. Because of simplicity of application, universal access, and low cost, centrifugal pumps are commonly used for short-term mechanical cardia c assist. Indications and techniques for application of this technology con tinue to evolve. Methods. The clinical experience with 151 patients undergoing centrifugal m echanical cardiac assist at the University of Missouri-Columbia has been re viewed. We have compared commonly available centrifugal pumping systems in vitro and in vivo for characteristics that might distinguish them. Results. Centrifugal pumps have been found to be well suited for use in sur gery on the thoracic aorta, for extracorporeal membrane oxygenation and for postcardiotomy cardiac mechanical assist. Complications associated with ce ntrifugal mechanical assist are predictable and common but potentially can be reduced by improved surgical techniques and anticoagulation strategies. In vitro and in vivo experimentation with available centrifugal pumps revea ls nuances characteristic of each of the devices. Conclusions. All centrifugal pumps presently available are less destructive to blood cellular elements compared with roller pumps. With familiarity, a ll can function satisfactorily for short-term mechanical assist with no com pelling evidence that favors any particular centrifugal pump system clinica lly available. Centrifugal pumps are ideally suited for left heart bypass d uring surgery on a thoracic aorta and for short-term application as may be required for postcardiotomy mechanical assist. Centrifugal pump technology should be part of the armamentarium of all cardiothoracic surgeons. (C) 199 9 by The Society of Thoracic Surgeons.