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KMID : 0364020090420050604
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Korean Journal of Thoracic and Cardiovascular Surgery
2009 Volume.42 No. 5 p.604 ~ p.609
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Percutaneous Cardiopulmonary Support (PCPS) for Patients with Cardiopulmonary Bypass Weaning Failure during Open Heart Surgery
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Ryu Kyoung-Min
Park Seong-Sik
Seo Pil-Won
Ryu Jae-Wook
Kim Seok-Kon
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Abstract
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Background: Recently, percutaneous cardiopulmonary support (PCPS) has been widely used to rescue patients in cardiogenic shock or cardiac arrest. However, patients with cardiopulmonary bypass (CPB) weaning failure during open heart surgery still have very poor outcomes after PCPS. We investigated clinical results and prognostic factors for patients who underwent PCPS during open heart surgery.
Material and Method: From January 2005 to December 2008, 10 patients with CPB weaning failure during open heart surgery underwent PCPS using the CAPIOX emergency bypass system (EBS?, Terumo Inc, Tokyo, Japan). We retrospectively reviewed the medical records of those 10 patients.
Result: The average age of the patients was 60.2±16.5 years (range, 19∼77 years). The mean supporting time was 48.7±64.7 hours (range, 4∼210 hours). Of the 10 patients, 6 (60%) were successfully weaned from the PCPS While 5 (50%) were able to be discharged from the hospital. Complications were noted in 5 patients (50%). In univariate analysis, long aortic cross clamp time during surgery, mediastinal bleeding during PCPS and high level of Troponin-I before PCPS were significant risk factors. All of the discharged patients are still surviving 34±8.6 months (range, 23∼48 months) post-operatively.
Conclusion: The use of PCPS for CPB weaning failure during open heart surgery can improve the prognosis. More experience and additional clinical studies are necessary to improve survival and decrease complications.
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KEYWORD
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Extracorporeal circulation, Postcardiotomy cardiogenic shock, Percutaneous cardiopulmonary support
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