Disposable Membrane Oxygenator Support During Emergency Coronary Angiography and During Surgery for Acute Myocardial Infarction or Chronic Myocardial Ischemia

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Abstract
Forty-two patients received successful total cardiopulmonary support with the effective, easy to use, completely disposable, Lande-Edwards Membrane Oxygenator. In 4 patients, partial cardiopulmonary support was provided with the Membrane Oxygenator and/or intra-aortic baloon pump during emergency coronary arteriography and corrective cardiac surgery for shock, following myocardial infarction. Two Landé—Edwards membrane oxygenators, 3 m2, were connected in parallel and joined in either a recirculation circuit or, more recently, a simplified gravity circuit. Three oxygenators were used for patients 80 kg to 103 kg body weight. Effective gas exchange was documented by the normal range of arterial and venous oxygen and carbon dioxide levels during flow rates of 50 cc/kg/min at 30°C. Safety of perfusion was demonstrated by 25 of 26 patients being discharged improved after complex aortocoronary artery by-pass graft operations. Minimal side effects were observed including plasma hemoglobin under 100 mg%, platelet counts 69 000 to 200 000/cu mm, less mental sequelae than with the Bentley Bubble oxygenator as measured by the Bender Gestalt psychometric tests and clinical observations, fewer blood transfusions because of less postoperative oozing, and less postoperative pulmonary dysfunction. Veno-arterial mechanical cardiopulmonary support with the membrane oxygenator and/or intra-aortic balloon pump during shock following myocardial infarction temporarily corrected the shock and allowed emergency coronary arteriography and corrective surgery. We recommend the compact, entirely disposable, simple to use Landé-Edwards Membrane Oxygenator be considered for complex cardiac operations and for temporary preoperative support during shock following myocardial infarction.