[A successful case of left heart bypass with biocompatible bypass circuit and minimal heparin for severe heart failure after open mitral commissurotomy].

A successful case of left heart bypass (LHB) for severe heart failure after mitral commissurotomy is presented. A 44-year-old woman underwent surgery for mitral and tricuspid regurgitation, then could not be weaned from cardiopulmonary bypass because of low cardiac output and intractable ventricular arrhythmia. The LHB from right-sided left atrium to ascending aorta was instituted with anti-thrombogenic centrifugal pump system (Carmeda). During initial 6 hours of LHB, any anticoagulant drugs were not employed, thereafter the local administration of heparin into left ventricle was started with a dose of 200 unit per hour. The LHB was successfully weaned at 26 hours after institution. Her postoperative course was uneventful. The left heart bypass without systemic heparinization utilizing anti-thrombogenic material might be a safe and useful method for postcardiotomy cardiogenic shock.