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Ann Thorac Surg 2000;70:1259-1263
© 2000 The Society of Thoracic Surgeons

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Original articles: cardiovascular

Bridge to recovery for postcardiotomy failure: is there still a role for centrifugal pumps?

^a Division of Cardiovascular and Thoracic Surgery, OSF St. Francis Medical Center, Peoria, Illinois, USA
^b Downstate Heart Transplant Center at OSF St. Francis Medical Center, Peoria, Illinois, USA

Address reprint requests to Dr Hoy, Illinois Cardiac Surgery Associates, 515 NE Glen Oak, Suite 202, Peoria, IL 61603

Background. Early implantation of centrifugal devices in patients with postcardiotomy cardiogenic shock may provide a bridge to recovery and allow subsequent long-term survival.

Methods. Since January 1989, 62 patients were supported with centrifugal pumps because of failure to wean from cardiopulmonary bypass. Indications were postcardiotomy cardiogenic shock (PCCS) (n = 60), bridge to cardiac retransplantation (n = 1), and right ventricular failure (n = 1). Patients’ ages ranged from 23 to 78 years; 40 were men (65%), and 22 were women (35%). Twenty-two patients (35%) had a left ventricular assist device; 9 patients (15%) had a right ventricular assist device; and 31 patients (50%) had a biventricular assist device. Length of support ranged from 1 day to 19 days.

Results. Forty-two patients (68%) were weaned successfully; 27 patients survived to discharge (44%). Complications included bleeding (n = 41, 66%), renal failure (n = 28, 45%), and respiratory failure (n = 26, 42%). Currently, 23 patients survived 10 or more years (n = 1), 6 to 10 years (n = 7), 1 to 5 years (n = 10), and less than 1 year (n = 5).

Conclusions. Centrifugal pumps are available, easy to use, and relatively inexpensive. Our experience justifies their continued use as a bridge to recovery for patients with postcardiotomy cardiogenic shock, despite the availability and increasing use of more expensive devices.

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