Intraoperative timing may provide criteria for use of post-cardiotomy ventricular assist devices.

Published

Journal Article

When surgeons consider ventricular assist devices (VADs) for post-cardiotomy support, unnecessary delays and early use can have detrimental effects on patient outcome. The authors analyzed the timing of intraoperative events in all patients receiving post-cardiotomy VAD support at their institution during a 2-1/2 year period (N = 17). They used ability to wean patients from VAD support as a measure of outcome. Neither preoperative risk factors nor the timing of distinct intraoperative events (e.g., cross-clamp time, total bypass time, delay to VAD) significantly differed between those patients able (Group I, n = 9) and those unable (Group II, n = 8) to be weaned from VAD support. The authors did find, however, that the time intervals from completion of the cardiac procedure to insertion of either an intra-aortic balloon pump (time to IABP) or VAD (time to VAD) were predictive of outcome when normalized to the duration of the cardiac procedure (DCP). [Time to IABP]/DCP ratios of < 1.0 versus > 1.0 (p = 0.02) and [time to VAD]/DCP ratios of < 2.5 versus > 2.5 (p = 0.10) each segregated Group I and II patients, respectively. Appropriate timing criteria for VAD insertion may be predicted during surgery by consideration of the duration of the cardiac procedure. This approach may attenuate tendencies to delay VAD use without leading to premature VAD insertion in the post-cardiotomy setting.

Full Text

Cited Authors

  • Anstadt, MP; Tedder, M; Hegde, SS; Douglas, JM; Sperling, RT; White, WD; Van Trigt, P; Lowe, JE

Published Date

  • July 1992

Published In

Volume / Issue

  • 38 / 3

Start / End Page

  • M147 - M150

PubMed ID

  • 1457835

Pubmed Central ID

  • 1457835

Electronic International Standard Serial Number (EISSN)

  • 1538-943X

International Standard Serial Number (ISSN)

  • 1058-2916

Digital Object Identifier (DOI)

  • 10.1097/00002480-199207000-00006

Language

  • eng