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The Journal of Thoracic and Cardiovascular Surgery, Vol 93, 434-441, Copyright © 1987 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
WE Pae Jr, WS Pierce, JL Pennock, DB Campbell and JA Waldhausen
Short-term survival of patients who require ventricular assist pumping for
postcardiotomy cardiogenic shock has been encouraging and has provided
enough survivors to allow evaluation of long-term results. We observed nine
survivors, 39 to 69 years of age (mean = 54.6) for 10 to 53 months (mean =
31) after their discharge from the hospital. In three patients, the
angiographic ejection fraction was normal before the operation, whereas in
six patients it was moderately to severely impaired. All nine patients were
in New York Heart Association Functional Class IV before operation. After
operation, eight of the nine patients were in Functional Class I or II. In
the remaining patient, the ejection fraction fell markedly and the
postoperative functional class remained unchanged. Two patients were
employed full- time and one, part-time. Five patients were retired but
active and had no cardiac disability, although two of the five did have
residual partial noncardiac disability. The remaining patient, a housewife,
continued to have compensated congestive heart failure but was relieved of
angina. During the follow-up period, five of the nine patients died
suddenly after 12, 18, 25, 30, and 38 months from causes that included
pulmonary embolus and probable arrhythmias. Survivors who have had
ventricular assist pumping for postcardiotomy cardiogenic shock have a good
chance of resuming active lives. The risk of being a "cardiac cripple" is
small, as is the risk of significant noncardiac disability.
ARTICLES
Long-term results of ventricular assist pumping in postcardiotomy cardiogenic shock
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