Clinical Application of Urgent Percutaneous Cardiopulmonary Support System in Patients with Cardiogenic Shock

To assess the efficacy of percutaneous cardiopulmonary support system (PCPS), we studied 16 patients supported urgently by PCPS (11 males, 5 females, mean age: 61 years). The reasons for indicating PCPS were cardiogenic shock in 10 patients, cardiac rupture in 3 patients and ventricular fibrillation (Vf) in 3 patients. Fourteen patients (88%) had ischemic heart disease (IHD). The remaining 2 patients had dilated cadiomyopathy and valvular heart disease, respectively. In five patients (31%), PCPS was used in combination with intraaortic balloon pump support. Finally, 4 patients (25%) survived: 1 patient with Vf and 3 patients with IHD. All of these 3 patients with IHD succeeded in coronary revascularization under the support of PCPS. The remaining patient succeeded in the termination of Vf after operating PCPS. No patient studied in the present study had vascular injury. However, 2 patients had severe mediastinal bleeding due to cardiopulmonary resuscitation, one of whom died of hemorrhagic shock. In conclusion, early coronary revascularization following PCPS is important to recover from cardiogenic shock because cardioprotective effect of PCPS is poor. Anti-coagulation therapy in operating PCPS sometimes induces severe hemorrhagic complications, to which we should pay attention.