A Recovery Case of Severe Heart Failure after Emergency Coronary Artery Bypass Grafting Supported by a Left Ventricular Assist System / 日本心臓血管外科学会雑誌

ABSTRACT

In general strategy for postcardiotomy heart failure includes inotropic support followed by the use of an intra-aortic balloon pump and percutaneous cardiopulmonary bypass support (POPS). The insertion of a ventricular assist system (VAS) may become necessary when these procedures fail to restore hemodynamic stability. The ABIOMED BVS 5000 left ventricular assist support system (LVAS) has been approved for clinical use in Japan since 1998. Here we describe our experience with the recovery of a 52-year-old man from postcardiotomy heart failure after using an ABIOMED BVS 5000 LVAS. The patient was admitted to our institution with dyspnea. Heart failure with severe left ventricular dysfunction was diagnosed, and recent myocardial infarction was suspected from his history and electrocardiogram. Two days after admission, ventricular fibrillation occured and the arrythmia was hard to control. PCPS was connected and emergency coronary angiography showed triple vessel disease. We performed emergency coronary artery bypass grafting with the heart beating under PCPS and immediately implanted an ABIOMED BVS 5000 device to achieve myocardial recovery after stopping PCPS. He was weaned from the LVAS at 6 days after surgery. His postoperative course was relatively uneventful and he was discharged after recovery.