Experiences with closed chest, temporary atrio-arterial, ventricular bypass with a centrifugal pump after open heart surgery.

Twelve patients with refractory myocardial failure following open heart surgery were treated with a temporary left (10), right (1) or biventricular (1) assist circuits driven by extracorporeal pumps. Ten of 11 patients were weaned from the pump oxygenator. During left ventricular assist, maximal pump flow was 2.2 +/- 0.6 l/min per m2 at a cardiac index of 2.5 +/- 0.9 l/min per m2. Diuresis was above 1 ml/kg body weight per h in 7 of 9 patients perfused for 13-36 h. Seven patients were weaned from the assist pump after 13-33 h of ventricular bypass with 4 hospital survivors. Two patients died after circulatory assistance of multiple organ failure, 1 from cerebral damage. In the other patients, the main problems were cardiac. Three patients are currently long term survivors 12-17 months after surgery.