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Postoperative circulatory support in adult cardiac surgery: recent experience from one center
Critical Care volume 7, Article number: P20 (2003)
Between December 1998 and December 2001, circulatory support (CS) was used in seven patients submitted to cardiac surgery in our institution.
The sample was composed of seven patients whose age varied from 32 to 78 years old (mean 51.85 years), and there were five male and two female patients. Coronary artery bypass grafting was performed in six patients and mitral valve replacement in one. Four patients presented failure of one ventricle and three had failure of both ventricles in the immediate postoperative period.
The system most commonly used was the Bio-pump® centrifugal pump, used in all cases; in one case biventricular support with the Bio-pump was changed after 48 hours to a biventricular DAV-InCor® system (temporary pulsatile ventricular assist device). Intra-aortic balloon pumping was used as secondary support in four cases with the aim of delivering a pulsatile flow.
The mean support time was 51 hours and 38 min/patient, the shortest time was 4 hours and 6 min, and the longest was 151 hours and 20 min.
There were five deaths during CS and the cause of them all was multiple organ failure. Two patients were discharged from CS (28% removal), one was bridged to emergency heart transplant and the other recovered ventricle function (bridge to recovery). The patient bridged to recovery is now in 12 months of followup, and in New York Heart Association class II.
Although the mortality index is still high (86%), we were able to bridge 28% of the patients to a more definitive treatment or status (transplant or recovery). The overall survival was 14%, but long-term survival of bridged patients is 50% and we expect to increase it in the near future.
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Martins, S., Arrais, M., Oliveira, D.d. et al. Postoperative circulatory support in adult cardiac surgery: recent experience from one center. Crit Care 7, P20 (2003). https://doi.org/10.1186/cc2216
- Mitral Valve
- Coronary Artery Bypass Grafting
- Valve Replacement
- Artery Bypass Grafting
- Multiple Organ Failure