Bio-medicus centrifugal ventricular support for postcardiotomy cardiac failure: A review of 129 cases

Background. Bio-Medicus centrifugal ventricular support has been used widely for postcardiotomy cardiac failure. The purpose of this study was to review a large series of support patients examining complications and outcomes. Methods. One hundred twenty-nine patients undergoing cardiac operations at The Methodist Hospital in Houston, Texas, were placed on Bio-Medicus centrifugal ventricular support for postcardiotomy cardiac failure; 102 were male and 27 were female with a mean age of 61.6 years. These patients were selected for ventricular support based solely on failure to be weaned from cardiopulmonary bypass or progressive postcardiotomy cardiac failure shortly after arrival in the intensive care unit. Results. These patients experienced numerous complications including coagulopathy, renal insufficiency or failure, sepsis, neurologic deficits, ventricular failure, arrhythmias, and death; 56.3% of patients were weaned from mechanical support and 21.0% were discharged alive. Causes of death included ventricular failure (62.4%), arrhythmias (12.9%), triage (6.9%), perioperative myocardial infarction or cardiac arrest (5.0%), coagulopathy (4.0%), sepsis syndrome (4.0%), cardiac graft failure (3.0%), and device related (1.0%). The one device-related death was a venous cannula dislodgment in the intensive care unit with subsequent exsanguination. Device-related complications were seen in only 1.6% of patients. Conclusions. Bio-Medicus centrifugal ventricular support can be implemented rapidly and relatively easily. There are few device-related complications and the cost is relatively inexpensive compared with other assist systems. This series demonstrates that a substantial number of patients who experience reversible postcardiotomy myocardial injury will benefit from temporary centrifugal ventricular support.