Balloon Counterpulsation Together with Bio-Medicus Pump Closed Circuit Membrane Oxygenation for Left Ventricular Assist: A Case Report

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Abstract
A 23-year old male was admitted at 1,093 days post cardiac transplantation in cardiac failure. Despite inotropic support and later intra-aortic balloon pumping there was a slow continued fall in cardiac output, renal function and a worsening metabolic state. The patient was then placed on extracorporeal membrane oxygenation (ECMO), consisting of a Bio-Medicus pump and Kolobow membrane oxygenator in a closed circuit configuration (without reservoir). Vascular access was by femoral artery and vein using a non-obstructive technique. Anticoagulation management consisted of a heparin infusion of 2,000 Iu/hour into a peripheral line to an ACT of 170 seconds and a prostacyclin infusion of 3ng/Kg/min. into the venous line.Induction of ECMO was followed by a rapid hemodynamic and metabolic improvement allowing the patient to sit up, talk and eat normally. One hundred and one hours later a new donor organ was located and transplanted.This system has much to recommend it. The equipment forms a compact module. The device functions safely with minimal perfusionist supervision. The system produces excellent offers effective short and medium term support for a range of cardiac and pulmonary disorders. hemodynamic function and offers effective short and medium term support for a range of cardiac and pulmonary disorders.

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