Percutaneous initiation of cardiopulmonary bypass.

Improved technology has allowed us to develop support pumps that can be applied rapidly and safely. A system utilizing thin-walled (4 mm inner diameter) percutaneously inserted sheaths has been designed for rapid bedside arterial and central venous cannulation to establish femoral arterial and venous cardiopulmonary bypass. The system utilizes two 30-cm-long large-bore, thin-walled (end and side holes) venous cannulas and a single 15-cm-long (end hole) arterial reperfusion cannula, which is connected to a pediatric oxygenator and a vortex pump head. Five patients with refractory cardiac arrest who could not be resuscitated by conventional means were revived with this system. Application time was approximately five minutes. This system appears to be an easily applied and reliable short-term mechanical support device.