Strategies for temporary mechanical support: Contemporary experience with pulsatile and non-pulsatile support systems

Nader Moazami, Marc R. Moon, Michael K. Pasque, Jennifer S. Lawton, Marci S. Bailey, Ralph J. Damiano

Research output: Contribution to journalArticlepeer-review

Abstract

Despite advances in mechanical circulatory support, cardiogenic shock continues to have a high mortality. We reviewed our experience with pulsatile versus non-pulsatile temporary mechanical support at our institution to determine optimal strategy for survival. From January 2001 to December 2003, mechanical support for cardiogenic shock was instituted in 38 patients. Non-pulsatile devices (NP group) were used in 22 patients and pulsatile devices (P group) in 16 patients. Indications for the NP group were post-cardiotomy shock (PCS) in 17, myocardial infarction in 2, and isolated post-cardiotomy right ventricular failure in 3 patients. In the P group, 9 had the device placed for PCS, 3 for viral myocarditis, 1 after myocardial infarction, and 3 for right ventricular (RV) failure. Overall, bleeding, limb ischemia, and multi-system organ failure were higher in NP group with 5 weaned and 3 surviving to discharge (14%). In the P group, survivors included 7 weaned and 3 transplanted patients (63 %). With the exception of isolated RV failure, we obtained a dismal survival result with ECMO/centrifugal circuits for treatment of cardiogenic shock. For refractory pump failure, improved survival was achieved by using intermediate-term pulsatile devices with early transition to a chronic device and/or heart transplantation.

Original languageEnglish (US)
Pages (from-to)215-219
Number of pages5
JournalHeart Surgery Forum
Volume8
Issue number4
DOIs
StatePublished - Dec 1 2005
Externally publishedYes

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine

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