Peripheral cardiopulmonary support during high-risk angioplasty

We report the safety and feasibility of the first three patients using cardiopulmonary bypass support at the Indiana University Medical Center during PTCA. All patients had severe left ventricular dysfunction. Cannulation was performed using 18- or 20-French cannulae of the femoral vessels, either surgically or percutaneously. After heparinization with an activated clotting time of greater than 450 seconds, cardiopulmonary bypass was instituted using the Bard CPS system. Flows ranged from 3.0 to 4.3 L/min. Normasol was used to prime the pump. Blood was retransfused back into the patient at the end of the procedure. Bleeding was a problem in case 1 at the arterial cannulation site and subsequently was corrected for cases 2 and 3. Coronary angioplasties were deemed technically successful. We conclude that high-risk angioplasty can be performed in patients with poor left ventricular function using cardiopulmonary bypass support in the cardiac catheterization laboratory. Further study is indicated.