Abstract
Between January 1990 and September 1992, ten patients required assisted circulation for postcardiotomy heart failure which was unresponsive to inotropic drugs and aortic counterpulsation. All patients were supported by a Bio-Medicus centrifugal pump (biventricular assist in Ave, left ventricular in three, right ventricular in two); six had ischaemic heart disease, two a congenital ventricular septal defect, one an acute mitral valve incompetence and one an aortic type ‘A’ dissection. The mean duration of circulatory support was 5.1 days (range 2 hours to 8 days). Six patients were weaned from the device and four were discharged; the perioperative deaths among the patients weaned from support were the result of cerebral haemorrhage and multiorgan failure respectively. No late deaths occurred at a mean follow-up of 15 months. Common complications were bleeding (40%), acute renal failure (30%) and sepsis (30%). All patients who developed renal failure died. The high incidence of haemorrhagic complications makes the use of pre-heparinized circuits desirable as these patients do not then require additional anticoagulation.
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