Electronic Resource
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:
Blackwell Science Inc
Journal of cardiac surgery
18 (2003), S. 0
ISSN:
1540-8191
Source:
Blackwell Publishing Journal Backfiles 1879-2005
Topics:
Medicine
Notes:
Abstract Background: Less invasive operation procedures without support of extracorporeal circulation are becoming increasingly important. A basic requirement for good long-term results in such cases is, however, the complete revascularization of the affected coronary vessels. The unsatisfactorily high conversion rate from bypass operations originally planned as off-pump to conventional operations with heart-lung machines, because of the failure to reach the target vessels on the rear wall of the heart through hemodynamic instability led to investigation of the efficiency of a microaxial pump (Impella elect) placed in the left ventricle. Methods: In a prospective project 15 of 38 consecutive patients selected for coronary revascularization with beating heart had a micro pump transaortically implanted in the left ventricle to support the heart during the operation with a flow rate of 2.5 to 3.9 l/min. Results: With 8 of 23 patients operated on without pump support, the operation had to be converted to conventional methods with a heart-lung machine. Only one patient out of the left-ventricle-supported group had to be further operated on conventionally because of a deep intramyocardial positioned left anterior descending coronary artery (LAD) (p 〈 0.05). The investigated laboratory parameters, especially creatine kinase (CK), CK-MB isoenzyme, and clotting showed no significant difference. There tended to be a higher blood loss recorded with the pump-supported patients. Conclusion: In summary, it appeared that the application of a left ventricular coaxial pump with comparable results seemed to make possible complete revascularization in nearly all patients.(J Card Surg 2003;18:240-244)
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1046/j.1540-8191.2003.02022.x
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