[Left heart bypass using a centrifugal pump as an adjunct measure for surgery of thoracic descending aorta].

We have employed left heart bypass (LHB) using a centrifugal pump with heparin coated tubes as an adjunct measure for surgery of thoracic descending aortic aneurysm in 8 cases. During aortic cross-clamping, LHB was controlled to maintain the distal pressure above 50 mmHg. In 7 cases, hemodynamics were stable and no complication occurred in relation with this method. However, acute heart failure due to coronary insufficiency occurred in one patient, and subsequent cardiopulmonary bypass was required to maintain systemic circulation. LHB provides adequate distal perfusion and proximal decompression in most cases, and it has also contributed to diminution of intraoperative bleeding. However, LHB can not maintain distal perfusion when acute heart failure occurs, which indicates that we have to select another adjunct measures, such as femorofemoral bypass to avoid distal hypoperfusion in cases with heart diseases.