Pii: 0002-9149(94)90813-3

Percutaneous cardiopulmonary bypass (PCB) was hmtttuted in 30 initially stable patients who developed either ctadiac arrest refractory to resuscitatton (n = 7) or cardiogenic shock (mean arts rial biood pressure cB0 mm Hg unresponsive to fluid resuscttation or vv) (n = 23) after a cation laboratory complication. Events leadhrg to collapse included abrupt closure during pe muaneous transkrminal coronary an~opiasty (P7CA) (n = 22), complications from dh#nostic cardiac catheterization (n = 6), left ventftcular perfo&ion duttng mitral valvule plasty (n q 1), and right ventricular perforation during pericardiocente& (n = 1). PCB was initiated within 20 minutes of cardiovascuiar collapse in 33% of patii (atvesk 21+ 13 minutes [range 10 to 501; and sho& 17 + 6 minutes [range 10 to 301). Mean arterial blood pressure i~onPCBfromOtoB6mmHginps tients with cardiac arrest and from 37 to 63 mm Hg in those with cardiogenic shock at mean PCB flow rates of 2.5 to 5.0 iiirs/min. Subsequent therapy on PCB included emergent cardiac surgery (n q 19, P7CA (II = 13) and medial therspy (n q 3). Six patients (20%) survived to hospital dischar@ (3 with cardiac sur@ry, 2 with PTCA, and 1 with medical therapy). All 7 patients with refractory cardiac arrest died despite further interventions on PCB, whereas 6 of 23 (26%) with cardiogenic shock survived to hospital discharge. Thus, in response to cardiovascular collapse in the catheterization laboratory, PCB does not salvage patients who do not r-e= gain a stabte cardiac rhythm. PCB can stabilize patients who develop cardiogenic shock for further interventions whi& are Bfesaving in only a minoftty of patients. (Am J Cardiol1994;73:872-375)