J.Jpn. Surg. Soc.. 94(10): 1153-1158, 1993

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Original article

CLINICAL EXPERIENCE OF VA-BYPASS AS A CARDIAC ASSIST SYSTEM USING CENTRIFUGAL PUMP WITH MEMBRANOUS OXYGENATOR IN PATIENTS WITH PROFOUND VENTRICULAR FAILURE AFTER CARDIAC SURGERY

Twelve patients including 6 ischemic heart diseases, 5 valvular diseases, and one adult atrial septal defect combined with mitral and tricuspid valve insufficiency were treated with circulatory assist system for postoperative severe low-cardiac output syndrome. Intra-aortic balloon pumping (IABP) was used in all cases. In early 7 cases, left heart bypass system was employed including one roller pump,one left ventricular assist device (LVAD), and 5 centrifugal pump. Only one LVAD case could be weaned but died of sustained ventricular arrhythmias 5 days postoperatively. In recent 5 cases, veno-arterial bypass (VA-bypass) was employed using centrifual pump with membranous oxygenator. Venous blood was drained from the right atrium and oxygenated blood was returned to the right axillar artery. Real time reinfusion of drained blood from intrapericardial and mediastinal tube to the central vein served efficiently to maintain hemodynamics and to save homologous blood transfusion. Three of 5 cases who were treated with Va-bypass survived and are doing well.
We conclude that VA-bypass consisting with centrifugal pump and oxygenator returning oxygenated blood to the right axillar artery combined with IABP were useful strategies as biventricular support for profound cardiac failure following surgery.

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