Literature DB >> 10077889

Therapeutic strategy of perioperative use of percutaneous cardiopulmonary bypass support (PCPS) for adult cardiac surgery.

S Sasaki1, K Yasuda, Y Matsui, K Aoi, S Gando, O Kemmotsu.   

Abstract

SUBJECT AND
METHOD: Percutaneous cardiopulmonary bypass support is beneficial for patients with circulatory collapse. However, therapeutic strategies of percutaneous cardiopulmonary bypass support for post-cardiotomy LOS have not been determined. We reviewed 9 patients undergoing cardiac surgery and treated with percutaneous cardiopulmonary bypass support to determine an adequate strategy for perioperative use of percutaneous cardiopulmonary bypass support. Patients included 8 males and 1 female with a mean age of 56.4 +/- 3.9 years. Six patients with IHD underwent CABG for 5 and CABG + MVR for 1 patient and 3 patients with valvular disease underwent AVR, AVR + MVR, and Ross operation respectively. Indication for percutaneous cardiopulmonary bypass support was post-cardiotomy LOS in 7 and preoperative cardiogenic shock in 2 patients. All patients underwent IABP associated with percutaneous cardiopulmonary bypass support. Systemic blood pressure was regulated to 100-120 mmHg by percutaneous cardiopulmonary bypass support flow and with minimum inotropic supports.
RESULTS: Six of 9 patients (66.7%) were weaned from percutaneous cardiopulmonary bypass support and 5 patients were discharged. Five of 6 patients (83.3%) with IHD were weaned from percutaneous cardiopulmonary bypass support compared to 1 of 3 patients (33.3%) (p = 0.134) with valvular disease. Hemodynamic conditions in patients weaned from percutaneous cardiopulmonary bypass support were markedly improved within 40 hours of the introduction of percutaneous cardiopulmonary bypass support (mean percutaneous cardiopulmonary bypass support running time: 23.9 +/- 5.5 hrs). In contrast, those unable to be weaned from percutaneous cardiopulmonary bypass support (mean percutaneous cardiopulmonary bypass support running time: 84.3 +/- 6.3 hrs) showed no improvement and developed major complications such as cerebral damage or multiorgan failure.
CONCLUSIONS: Perioperative use of percutaneous cardiopulmonary bypass support may be more effective for patients undergoing coronary artery surgery. Limited use of percutaneous cardiopulmonary bypass support within 48 hours may be applicable for post-cardiotomy patients.

Entities:  

Mesh:

Year:  1999        PMID: 10077889     DOI: 10.1007/bf03217935

Source DB:  PubMed          Journal:  Jpn J Thorac Cardiovasc Surg        ISSN: 1344-4964


  15 in total

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Journal:  Ann Thorac Surg       Date:  1990-01       Impact factor: 4.330

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Authors:  S J Phillips; B Ballentine; D Slonine; J Hall; J Vandehaar; C Kongtahworn; R H Zeff; J R Skinner; K Reckmo; D Gray
Journal:  Ann Thorac Surg       Date:  1983-08       Impact factor: 4.330

4.  Percutaneous cardiopulmonary bypass support in high-risk patients undergoing percutaneous transluminal coronary angioplasty.

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Journal:  Am J Cardiol       Date:  1989-12-01       Impact factor: 2.778

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Authors:  K Kawahito; T Ino; H Adachi; H Ide; A Mizuhara; A Yamaguci
Journal:  ASAIO J       Date:  1994 Oct-Dec       Impact factor: 2.872

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Journal:  Ann Thorac Surg       Date:  1996-02       Impact factor: 4.330

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Authors:  H L Lazar; P Treanor; S Rivers; S Bernard; R J Shemin
Journal:  Ann Thorac Surg       Date:  1995-02       Impact factor: 4.330

8.  Enhanced recovery of ischemic myocardium by combining percutaneous bypass with intraaortic balloon pump support.

Authors:  H L Lazar; P Treanor; X M Yang; S Rivers; S Bernard; R J Shemin
Journal:  Ann Thorac Surg       Date:  1994-03       Impact factor: 4.330

9.  Percutaneous cardiopulmonary support as the second generation of venoarterial bypass: current status and future direction.

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Journal:  Artif Organs       Date:  1993-11       Impact factor: 3.094

10.  Percutaneous cardiopulmonary bypass: application and indication for use.

Authors:  S J Phillips; R H Zeff; C Kongtahworn; J R Skinner; R S Toon; A Grignon; R M Kennerly; W Wickemeyer; L A Iannone
Journal:  Ann Thorac Surg       Date:  1989-01       Impact factor: 4.330

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  1 in total

1.  Development and clinical application of minimally invasive cardiac surgery using percutaneous cardiopulmonary support.

Authors:  H Ohuchi; S Kyo; H Asano; H Tanabe; Y Yokote; R Omoto
Journal:  Jpn J Thorac Cardiovasc Surg       Date:  2000-09
  1 in total

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