VARIOUS PROBLEMS DURING LONG-TERM PERCUTANEOUS CARDIOPULMONARY SUPPORT

A 54-year-old man with a left ventricular free wall rupture following acute anterior myocardial infarction underwent a repair surgery with p ercutaneous cardiopulmonary support (PCPS). During surgery and postope ratively, PCPS provided sufficient support flow. The patient was succe ssfully weaned from PCPS on the 15th postoperative day and discharged subsequently. In the management of cardiac rupture patients, PCPS has the merit of preventing rupture progression and the advantage of recov ery of pulmonary function. However, there are several problems to solv e. The support effectiveness and recovery of the patient's heart shoul d be carefully evaluated. Effective left heart decompression also need s to be established. Heparin-coated circuits still need proper anticoa gulation treatment to prevent thrombus formation especially while supp ort flow is low. A circuit construction that allows easier maintenance and safer exchange of oxygenators and pump heads is suggested. Ischem ia of the cannulated leg should be prevented by femoral artery perfusi on.