Transport of Hemodynamically Unstable Patients by a Mobile Mechanical Circulatory Support Team

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Abstract
Advances in medical technology have made it possible to use emergency femoro-femoral bypass (FFB) for transport of hemodynamically unstable patients. In this study, we report on our experience of transport of patients with refractory heart failure by a special mobile mechanical circulatory support team (MMCST) using an intraaortic balloon pump (IABP) or FFB. A total of 22 patients (14 men, 8 women) were supported by the MMCST and transported to our clinic for further diagnostic or therapeutic procedures. The diagnoses in 12 patients was acute myocardial infarction, in 7 patients, dilatative cardiomyopathy (DCM), and in 3 patients, acute fulminant myocarditis. In 15 cases, FFB was implanted (5 in combination with IABP), and in 5 cases, IABP only was implanted. Two patients received maximal dosages of catecholamines. After arrival at our clinic, 11 patients received implants of a more sophisticated support system. From the myocardial infarction group, 3 patients received coronary artery bypass grafting, 1 patient received percutaneous transluminal coronary angioplasty, and 1 patient received heart transplantation as final therapy. In the myocarditis and DCM groups, 7 patients underwent heart transplantation. Finally, 11 patients (50%) survived, and 11 patients died of multiorgan failure or septicemia.