Placement of Long-term Implantable Ventricular Assist Devices Without the Use of Cardiopulmonary Bypass
Received 15 November 2007; received in revised form 8 February 2008; accepted 27 March 2008. published online 09 June 2008.
Background
Implantation of ventricular assist devices for cardiac support is normally performed using cardiopulmonary bypass. Post-operative complications could be minimized by the placement of these devices without the use of cardiopulmonary bypass.
Methods
We hypothesize that left ventricular assist devices (LVADs), in selected patients, can be implanted safely off-pump.
Results
In 25 patients, LVADs were implanted off-pump (mean age 50 years; 64% male, 36% female; average left ventricular ejection fraction 15%). Pre-operatively 68% of patients were on inotropes, 25% had an intra-aortic ballon pump, and 44% had a previous sternotomy. Blood utilization intra- and post-operatively was relatively minimal with 1 re-exploration for bleeding. There were 3 deaths.
Conclusions
We describe a technique for successful placement of a left ventricular assist device without the use of cardiopulmonary bypass.
Division of Cardiothoracic Surgery, The Ohio State University, Columbus, Ohio.
Reprint requests: Benjamin C. Sun, MD, Division of Cardiothoracic Surgery, The Ohio State University Medical Center, 841 North Doan Hall, Columbus, OH 23210. Telephone: 614-293-4558. Fax: 614-293-7221.