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The Annals of Thoracic Surgery, Vol 47, 130-135, Copyright © 1989 by The Society of Thoracic Surgeons

ARTICLES

Use of the Pierce-Donachy ventricular assist device in patients with cardiogenic shock after cardiac operations

DG Pennington, LR McBride, MT Swartz, KR Kanter, GC Kaiser, HB Barner, LW Miller, KS Naunheim, AC Fiore and VL Willman
Department of Surgery, St. Louis University Hospital, Missouri 63104.

In spite of recent improvements in cardiac surgery, a small percentage of patients have severe postcardiotomy ventricular failure refractory to drugs and the intraaortic balloon. In our experience, the Pierce- Donachy external pneumatic ventricular assist device has proved to be one of the most effective devices for these patients. Since 1981, 30 patients aged 15 to 71 years (mean age, 52 years) with profound cardiogenic shock refractory to conventional therapy after cardiotomy were supported with the Pierce-Donachy ventricular assist device. Fourteen required left ventricular support, 7 needed right ventricular support with an intraaortic balloon, and 9 had biventricular assistance. Duration of support ranged from three hours to 22 days (mean length, 3.6 days). Seven of the first 11 patients seen died in the operating room of bleeding, biventricular failure, or both. However, 16 patients (53%) had improved cardiac function, 15 (50%) were weaned, and 11 (37%) were discharged. Of the last 19 patients in the series, 47% survived. Factors affecting survival were myocardial infarction (75%) and renal failure (90%). Common complications were bleeding (73%) and biventricular failure (83%).

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