[Assisted circulation with centrifugal pump for cardiogenic shock after extracorporeal surgery]

A 59 year old woman with aneurysm of the left ventricle anterior wall developed heart failure, class III-IV (NYHA). The radioisotopic angiography showed left ventricular function impairment, ejection fraction of 16% and the aneurysm. She was submitted to aneurysm correction with bovine pericardium patch. In spite of technically successful cardiac surgery, the patient cannot be weaned from cardiopulmonary bypass with maximal pharmacological therapy and intra-ortic balloon pump. Then, we used Biomedicus centrifugal pump for left ventricular assistance. Cannulation was made by aorta and left atrial appendage. Myocardial function evolution was accompanied by hemodynamic parameters and by intra-esophagic echocardiography. The patient was assisted during 42 hours. After this time, assist cannulas were removed in operating room without difficulty. She was submitted to another radioisotopic study on the 50th post-operative day and ejection fraction was 24%. She was discharged from hospital at 52th post-operative day. Nowadays she is in NYHA class II at third post-operative month. More frequent utilization of circulatory assistance devices will reduce global mortality from cardiac surgery and improve safety in surgery of severe cardiac disease.