Heart and Vessels

, Volume 11, Issue 1, pp 27–29 | Cite as

Emergency cardiopulmonary bypass support in patients with severe cardiogenic shock after acute myocardial infarction

  • Ryousuke Matsuwaka
  • Tetsuo Sakakibara
  • Hideo Shintani
  • Akihiko Yagura
  • Takafumi Masai
  • Atsushi Hirayama
  • Kazuhisa Kodama
Originals

Summary

A total of 16 patients who developed severe cardiogenic shock were resuscitated with a percutaneous cardiopulmonary support system (PCPS). The etiology of shock was acute myocardial infarction (n = 7), or post-infarction left-ventricular (LV) free wall rupture (n = 9). After successful resuscitation with the PCPS, 15 patients underwent therapeutic interventions: closure of an LV rupture (n = 9), coronary artery bypass grafting (n = 4), percutaneous transluminal angioplasty (n = 1), and percutaneous transluminal coronary recanalization (n = 1). Of the 16 patients, 14 were weaned from PCPS or standard cardiopulmonary bypass. Six patients survived longer than 30 days, 3 (19%) of whom were discharged from the hospital. The long-term survival rate in the 6 patients who underwent coronary revascularization was 33% (2/6). Of the 9 patients with LV free wall rupture, 1 was discharged from the hospital. Even though it cannot be concluded, from this small number of patients, that cardiopulmonary resuscitation using PCPS improves survival, it appears that PCPS is a powerful resuscitative modality for seriously ill patients with acute myocardial infarction or LV rupture.

Key words

Percutaneous cardiopulmonary bypass Acute myocardial infarction Cardiac arrest 

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References

  1. 1.
    Mooney MR, Arom KV, Joyce LD, Mooney JF, Goldenberg IF, Von Rueden TJ, Emery WF (1991) Emergency cardiopulmonary bypass support in patients with cardiac arrest. J Thorac Cardiovasc Surg 101:450–454PubMedGoogle Scholar
  2. 2.
    Reichman RT, Joyo CI, Dembitsky WP, Griffith LD, Adamson RM, Dailey PO, Overlie PA, Smith SC, Jaski BE (1990) Improved patient survival after cardiac arrest using a cardiopulmonary support system. Ann Thorac Surg 49:101–105PubMedGoogle Scholar
  3. 3.
    Hill JG, Bruhn PS, Cohen SE, Gallagher MW, Manart F, Moore CA, Seifert PE, Askari P, Banchieri C (1992) Emergent applications of cardiopulmonary support: A multiinstitutional experience. Ann Thorac Surg 54:699–704PubMedGoogle Scholar
  4. 4.
    Rouson JA, Engleman RM, Flack JE, Deaton DW, Owen SG (1994) Emergency cardiopulmonary bypass in the cardiac surgical unit can be a lifesaving measure in postoperative cardiac arrest. Circulation 90 [Part 2]:280–284Google Scholar
  5. 5.
    Shawl FA, Domanski MJ, Wish MH, Davis M, Punja S, Hernandez TJ (1990) Emergency cardiopulmonary bypass support in patients with cardiac arrest in the catheterization laboratory. Cathet Cardiovasc Diagn 19:8–12PubMedGoogle Scholar
  6. 6.
    Mori Y, Ueno K, Hattori A, Kim T, Aoyama T, Segawa T, Mimoto H, Tomita R, Tanaka T, Mori N (1994) Emergency cardiopulmonary support in patients with cardiac arrest caused by myocardial infarction. Artif Organs 18:698–701PubMedGoogle Scholar
  7. 7.
    Yasuda S, Nonogi H, Goto Y, Miyazaki S, Itoh A, Daikoku S, Sasako Y, Haze K (1995) Clinical application of urgent percutaneous cardiopulmonary support system in patients with cardiogenic shock (in Japanese). J Jpn Soc Intensive Care Med 3:101–106Google Scholar
  8. 8.
    Nishida H, Shibuya M, Kitamura M, Hachida M, Aomi S, Endo M, Hashimoto A, Koyanagi H (1993) Percutaneous cardiopulmonary support as the second generation of venoarterial bypass: Current status and future direction. Artif Organs 17:906–913PubMedGoogle Scholar
  9. 9.
    Dembitsky WP, Moreno-Cabral RJ, Adamson RM, Daily PO (1993) Emergency resuscitation using portable extracorporeal membrane oxygenation. Ann Thorac Surg 55:304–309PubMedGoogle Scholar
  10. 10.
    Masai T, Matsuda H, Nakano S, Sakai K, Sakakibara T, Kaneko M, Miyamoto Y, Watanabe S, Matsuwaka R, Shintani H, Kawashima Y, Kodama K (1990) Development of a closed cardiopulmonary bypass system for temporary cardiopulmonary support and its clinical application (in Japanese). Jpn J Artif Organs 19:182–185Google Scholar
  11. 11.
    Sakakibara T, Matsuwaka R, Shintani H, Yagura A, Yamaguchi T, Hirayama A, Kodama K. Successful repair of postinfarction left ventricular free wall rupture: New strategy using hypothermic percutaneous cardiopulmonary bypass. J Thorac Cardiovasc Surg (in press)Google Scholar
  12. 12.
    Gibbon JH (1939) The maintenance of life during experimental occlusion of the pulmonary artery followed by survival. Surg Gynecol Obstet 19:602–614Google Scholar
  13. 13.
    Cooley DA, Beall AC (1961) A technique of pulmonary embolectomy using temporary cardio-pulmonary bypass: Clinical and experimental considerations. J Cardiovasc Surg 2:469–476Google Scholar
  14. 14.
    Mattox KL, Beall AC (1976) Resuscitation of the moribund patient using portable cardiopulmonary bypass. Ann Thorac Surg 22:436–442PubMedGoogle Scholar
  15. 15.
    Phillips SJ, Ballentine B, Slonine D, Hall J, Vandehaar J, Kongtahworn C, Reckmo K, Gray D (1983) Percutaneous initiation of cardiopulmonary bypass. Ann Thorac Surg 36:223–225PubMedGoogle Scholar
  16. 16.
    Phillip SJ (1986) Percutaneous cardiopulmonary bypass and innovations in clinical counterpulsation. Crit Care Clin 2:297–318PubMedGoogle Scholar
  17. 17.
    Hartz R, LoCicero J, Sanders J, Frederiksen JW, Joob AW, Michaelis L (1990) Clinical experience with portable cardiopulmonary bypass in cardiac arrest patients. Ann Thorac Surg 50:437–441.PubMedGoogle Scholar

Copyright information

© Springer-Verlag 1996

Authors and Affiliations

  • Ryousuke Matsuwaka
    • 1
  • Tetsuo Sakakibara
    • 1
  • Hideo Shintani
    • 1
  • Akihiko Yagura
    • 1
  • Takafumi Masai
    • 1
  • Atsushi Hirayama
    • 2
  • Kazuhisa Kodama
    • 2
  1. 1.Division of Cardiovascular SurgeryCardiovascular Center, Osaka Police HospitalOsakaJapan
  2. 2.Divisions of CardiologyCardiovascular Center, Osaka Police HospitalOsakaJapan

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