Hemopump treatment in patients with postcardiotomy heart failure.

BACKGROUND

This study examined the use of the Hemopump to treat low cardiac output syndrome after cardiopulmonary bypass.

METHODS

We used the Hemopump temporary cardiac assist system in 29 patients with severe left ventricular dysfunction after open heart operations from September 1991 to November 1994.

RESULTS

Five patients were excluded from the study due to initial patient/device-related problems. Ten patients died in the operating room or early during the stay in the intensive care unit due to progressive biventricular failure. Fourteen patients (58.3%) were weaned from the device, and all of them were later discharged. In a subgroup of patients (54%) in whom we had a more aggressive approach for early insertion of the pump, the survival rate was 85%. Preoperative Higging risk score was significantly related to survival.

CONCLUSIONS

The Hemopump can effectively unload a failing left ventricle with preservation of multiorgan perfusion. A minor decrease in kidney function was observed in most patients, but none of the surviving patients needed hemodialysis. One patient required a short period of peritoneal dialysis to get rid of fluid overload. Hemolysis or platelet dysfunction was not a clinical problem.