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Postcardiotomy centrifugal mechanical ventricular support.

L A Golding1, R D Crouch, R W Stewart

  • 1Cleveland Clinic Foundation, OH 44195.

The Annals of Thoracic Surgery
|December 1, 1992
PubMed
Summary
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Centrifugal mechanical ventricular assist devices offered a 25.3% hospital survival rate for postcardiotomy failure and bridge to transplant patients. Lower survival was linked to biventricular and renal failure, not patient age or sex.

Area of Science:

  • Cardiovascular Surgery
  • Medical Devices
  • Mechanical Circulatory Support

Background:

  • Mechanical ventricular assist devices (MVADs) are crucial for managing severe heart failure.
  • Centrifugal pumps represent a significant technology in MVADs.
  • Understanding outcomes of centrifugal MVAD use is vital for clinical practice.

Purpose of the Study:

  • To evaluate the efficacy and outcomes of centrifugal mechanical ventricular assist in patients with severe heart failure.
  • To analyze survival rates, morbidity, and long-term functional status after centrifugal MVAD support.
  • To identify factors influencing survival in patients supported by centrifugal ventricular assist devices.

Main Methods:

  • Retrospective analysis of 91 patients receiving centrifugal mechanical ventricular assist between 1979 and 1991.

Related Experiment Videos

  • Indications included postcardiotomy ventricular failure and bridge to cardiac transplantation.
  • Data collected on device duration, weaning success, hospital survival, morbidity, and long-term follow-up.

    • Main Results:

    • Hospital survival was 25.3% for postcardiotomy failure and bridge to transplant indications.
    • Major morbidities included bleeding (87.3%), renal failure (46.8%), and cerebrovascular events (12.7%).
    • Long-term follow-up showed 35% late mortality, with survival associated with absence of biventricular and renal failure.

    Conclusions:

    • Centrifugal mechanical ventricular assist demonstrated a modest survival benefit in critically ill cardiac patients.
    • Significant morbidity necessitates careful patient selection and management.
    • Biventricular and renal failure are critical predictors of poorer outcomes in patients supported with these devices.