Mechanical assistance for cardiogenic shock following cardiac surgery, myocardial infarction, and cardiac transplantation.

From January, 1982, to October, 1986, 33 patients were treated with either the Pierce-Donachy prosthetic ventricle or the Bio-Medicus ventricular assist device for cardiogenic shock following a cardiac operation, myocardial infarction, or cardiac transplantation. Twenty-five patients required the assistance for postcardiotomy shock and 8, for a variety of conditions including myocardial infarction shock and myocarditis, and as a bridge to cardiac transplantation. Complications were frequent and usually secondary to prolonged cardiopulmonary bypass. Results were poorest in the group with postcardiotomy shock. Earlier application of an assist device could lead to more frequent survival and avoidance of the detrimental effects of prolonged extracorporeal circulation.