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Coronary artery operation with support of the Hemopump cardiac assist system
U Lönn1, B Peterzén, H Granfeldt
1Linköping Heart Center, University of Linköping, Sweden.
Insights
This study demonstrates the safe use of the Hemopump cardiac assist system as an alternative to cardiopulmonary bypass for coronary artery bypass grafting. The novel approach supported patients effectively without complications, showing promising potential.
Area of Science:
- Cardiovascular Surgery
- Medical Devices
- Cardiac Assist Systems
Background:
- Cardiopulmonary bypass (CPB) is standard for coronary artery bypass grafting (CABG) but carries risks.
- Alternative circulatory support methods are needed to mitigate CPB-associated complications.
Purpose of the Study:
- To evaluate the feasibility and safety of using the Hemopump cardiac assist system during CABG.
- To assess the Hemopump's efficacy as a sole circulatory support and cardiac decompression device.
Main Methods:
- Five patients with one- or two-vessel disease underwent CABG using a 24F Hemopump in the left ventricle.
- The Hemopump provided circulatory support, replacing traditional cardiopulmonary bypass.
- Esmolol was administered to achieve cardiac flaccidity, and patients received heparin for anticoagulation.
Main Results:
- All five patients tolerated the procedure without complications, with an average Hemopump support time of 56 minutes.
- Hemodynamic values returned to baseline within 30 minutes post-pump removal.
- No patients required blood transfusions or experienced postoperative renal impairment.
Conclusions:
- The Hemopump cardiac assist system offers a viable alternative to cardiopulmonary bypass for CABG.
- This approach may avoid the drawbacks of CPB and cardioplegic arrest.
- Further evaluation in randomized controlled trials is warranted.
Abstract:
Five patients with one- or two-vessel disease had one to three bypass grafts using the Hemopump cardiac assist system instead of cardiopulmonary bypass to decompress the heart and as circulatory support. In addition, the short-acting beta-blocker esmolol was given as a bolus and stepwise titrated to make the heart flaccid and facilitate operation. All patients had a 24F Hemopump placed into the left ventricle. The patients were given 7,500 U of heparin. Average time on Hemopump support was 56 minutes. All patients went through the procedure uneventfully. Thirty minutes after pump removal all patients were back to baseline hemodynamic values. None of the patients needed blood transfusion. No postoperative renal impairment was seen. This method has great potential and could avoid the drawbacks associated with cardiopulmonary bypass and cardioplegic arrest. Careful evaluation in randomized studies is the next step.