This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Anna L. Meyer Martin Strueber Sandra Tomaszek Andre R. Simon Axel Haverich Stefan Fischer Permission Requests Google Scholar Articles by Meyer, A. L. Articles by Fischer, S. PubMed PubMed Citation Articles by Meyer, A. L. Articles by Fischer, S. Related Collections Mechanical Circulatory Assistance

Temporary cardiac support with a mini-circuit system consisting of a centrifugal pump and a membrane ventilator

Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany

*Corresponding author. Tel.: +49-511-532-3455; fax: +49-511-532-5404.

E-mail address: fischer.stefan{at}mh-hannover.de (S. Fischer).

Commonly used extracorporeal membrane oxygenation (ECMO) systems for cardiac support are limited by bleeding complications, especially after surgery in the adult patient. Recently, we have switched from the use of a conventional ECMO system to a miniature-circuit including a centrifugal pump and the Novalung^® membrane ventilator (iLA). This system allows us to administer less heparin compared to the conventional system. Between January and August 2007, 1469 patients underwent cardiac surgery at our center, of which 18 patients (1.2%) required temporary postoperative ECMO system support. Surgical procedures in these patients included coronary artery bypass grafting (CABG) surgery (n=5), valvular replacement (n=2), aortic surgery (n=2), cardiac transplantation (n=5), and other procedures (n=3). The mean age of the 18 patients was 50±15 years (n=13 male) with a mean duration of ECMO system support of 4.3 days (range: <1 to 14 days). Twelve patients (67%) were successfully weaned from ECMO system. The 30-day survival was 44% with a hospital mortality of 61%. Re-thoracotomy for bleeding was necessary in six patients (33%) under ECMO system support. In summary, the miniature ECMO system circuit seems to be suitable for middle-term cardiac support and is associated with a low rate of bleeding complications.

Key Words: Extracorporeal membrane oxygenation; Levitronix®; Centrifugal pump; Novalung®; Postcardiotomy; Temporary cardiac support