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Percutaneous cardiopulmonary bypass: application and indication for use
S J Phillips1, R H Zeff, C Kongtahworn
1Department of Cardiovascular Medicine and Surgery, Mercy Hospital Medical Center, Des Moines, Iowa.
The Annals of Thoracic Surgery
|January 1, 1989
Summary
Percutaneous cardiopulmonary bypass (CPB) effectively resuscitated most patients with circulatory collapse, including cardiac arrest from myocardial infarction and failed angioplasty. This technique showed promise for high-risk procedures but was not suitable for trauma cases.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Critical Care Medicine
Background:
- Percutaneous cardiopulmonary bypass (CPB) offers a less invasive approach to mechanical circulatory support.
- The application of percutaneous CPB in diverse critical care scenarios remains an area of active investigation.
Purpose of the Study:
- To evaluate the efficacy and applicability of percutaneous CPB in a cohort of patients experiencing circulatory collapse.
- To identify patient populations where percutaneous CPB demonstrates significant benefit.
Main Methods:
- A modified Seldinger technique was employed for percutaneous cannulation to establish CPB.
- The study included patients with acute myocardial infarction, failed angioplasty, pulmonary embolism, hypothermia, sepsis, refractory arrhythmia, and trauma.
Main Results:
- Percutaneous CPB successfully resuscitated 22 patients, with notable success in cases of cardiac arrest due to acute myocardial infarction and failed angioplasty.
- One patient with refractory cardiac arrest underwent successful triple-vessel angioplasty with percutaneous CPB support.
- The technique was not effective in patients with massive trauma.
Conclusions:
- Percutaneous CPB is a valuable resuscitation tool for refractory cardiac arrest and circulatory collapse, excluding trauma.
- Its use may be beneficial for brief support during high-risk elective angioplasty procedures.