Circulatory support with a centrifugal pump as a bridge to cardiac transplantation

R. Morton Bolmanz*, James Lewis Cox, William Marshall, Nicholas Kouchoukos, Thomas L. Spray, Connie Cance, Randall E. Genton, Jeffrey Saffitz

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

32 Scopus citations

Abstract

Since January 1985, the Heart Transplant Program at Washington University Medical Center, St. Louis, has performed 89 heart transplantations in 86 patients. Twenty patients (23%) have required preoperative mechanical support of circulation or respiration prior to transplantation. The Bio-Medicus centrifugal pump (Bio-Pump) formed the basis of our circulatory support system during the period of this report. Nine patients were placed on the Bio-Pump with the intention of bridging them to transplantation. Six patients required left ventricular assistance; in 2, the device was inserted because they could not be weaned from cardiopulmonary bypass. Two patients required biventricular assistance, 1 because she could not be weaned from cardiopulmonary bypass at the end of a cardiac operation. Extracorporeal membrane oxygenation was necessary in 1 patient for right ventricular decompensation and cardiac arrest four hours after orthotopic cardiac transplantation. One of these 9 patients died on circulatory support, and in another, a complication developed that precluded transplantation. The remaining 7 patients (78%) underwent a successful transplant procedure after an average of 1.6 days of circulatory support (range, 0,5 to three days), and all are long-term survivors of transplantation. There has been 1 late death at 17 months from a cerebrovascular hemorrhage. In summary, the centrifugal pump provides excellent short-term circulatory support for individuals who would otherwise die before cardiac transplantation.

Original languageEnglish (US)
Pages (from-to)108-112
Number of pages5
JournalThe Annals of thoracic surgery
Volume47
Issue number1
DOIs
StatePublished - Jan 1989

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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