Clinical Experience of Percutaneous Cardiopulmonary Support

Area of Science:

• Cardiovascular Surgery
• Medical Devices
• Critical Care Medicine

Background:

• Percutaneous cardiopulmonary support (PCPS) using femoro-femoral bypass without a reservoir is valued for its ease of application.
• Existing systems may have limitations in specific patient populations, such as those with active bleeding.

Purpose of the Study:

• To evaluate the efficacy and clinical outcomes of a novel, fully preconnected compact integrated cardiopulmonary bypass (CPB) unit designed for PCPS.
• To assess the utility of this CPB system in various clinical scenarios, including elective, urgent, and shock conditions.

Main Methods:

• Development and implementation of a compact integrated CPB unit with a 250 ml priming volume and a blind pore membrane oxygenator.
• Application of PCPS in 49 patients between 1990 and 1995, utilizing the integrated CPB unit or a heparin-bonded close chest support pack (CCSP) for active bleeding cases.
• Analysis of patient outcomes, including weaning from support, need for further procedures (e.g., left ventricular assist system - LVAS), and survival rates.

Main Results:

• Out of 49 patients, 26 were successfully weaned from PCPS.
• In elective cases (n=8), PCPS was uneventful, with all patients weaned or switched to LVAS.
• In urgent cases (n=8) and shock (n=32), PCPS provided circulatory support, enabling transitions to other procedures or LVAS, with some patients surviving.

Conclusions:

• The compact integrated CPB unit facilitates quick and easy setup, improving clinical results for acute circulatory support via PCPS.
• PCPS can effectively support circulation in the acute phase, providing crucial time for further interventions like surgery or LVAS implantation.
• Further improvements in PCPS outcomes may be achieved with enhanced surface technologies, such as heparin-bonding.