Mechanical ventricular support using pulsatile Abiomed BVS 5000 and centrifugal Biomedicus-pump in postcardiotomy shock

Abstract

Since we started using ventricular assist devices (VAD) in July 1987 up to August 1993, 63 of 15,650 (0.4%) patients (pts) who underwent open heart surgery were supported postoperatively by VAD at out institution. 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 pts (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 discharged. Twenty-three pts were unable to be weaned and 19 of these pts died. The remaining 4 pts were transplanted successfully and subsequently 3 died and 1 was discharged. In all, 15 pts (39%) were long-term survivors. 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 unable to be weaned and 7 of these died. The remaining 3 pts were transplanted 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, support time between 2 and 7 days and Abiomed pump, influence the survival rate positively.(ABSTRACT TRUNCATED AT 250 WORDS)

Differential indication for mechanical circulatory support following heart transplantation

“…Others report the treatment of PGF with LVAD [9,18] or with BVAD [16,17,19,20]. On the basis of an evaluation of more than 200 cases with MCS in our hospital [2,4,5,6,7] the advantages and disadvantages of the individual systems could be proven. The indications for the individual pumps were deduced from these data.…”

Mechanical circulatory support with the ABIOMED BVS 5000: The Toronto General Hospital experience

“…In the posttransplant group, three of six (50%) patients were weaned and two (33%) were successfully discharged home. Various investigators have reported encouraging results in this group, with wean rates ranging between 47% and 100%, and discharge rates between 20% and 71% (16)(17)(18)(19)(20). The available knowledge emphasizes the recoverability of ventricular function in the transplanted heart during primary graft failure or severe acute rejection with cardiogenic shock.…”

Perioperative Mechanical Circulatory Support in Children with Critical Heart Disease

“…The BioMedicus Centrifugal Pump (BCP) (Medtronic BioMedicus, Eden Prairie, MN) is a constant-speed, nonpulsatile device that can be used in children of all ages [53][54][55]. This pump is often used without a membrane oxygenator, establishing a different modality from traditional ECMO, and as such will be reviewed separately.…”