Clinical Experience Using the Levitronix CentriMag System for Temporary Right Ventricular Mechanical Circulatory Support

被引:89
作者
Bhama, Jay K. [1 ]
Kormos, Robert L. [1 ]
Toyoda, Yoshiya [1 ]
Teuteberg, Jeffrey J. [2 ]
McCurry, Kenneth R. [1 ]
Siegenthaler, Michael P. [1 ]
机构
[1] Univ Pittsburgh, Med Ctr, Heart Lung & Esophageal Surg Inst, Div Cardiac Surg, Pittsburgh, PA 15213 USA
[2] Univ Pittsburgh, Med Ctr, Cardiovasc Inst, Pittsburgh, PA 15213 USA
关键词
ASSIST DEVICE; BIVENTRICULAR SUPPORT; HEART-TRANSPLANTATION; FAILURE; BRIDGE; DECISION; PUMP;
D O I
10.1016/j.healun.2009.04.015
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Short-term mechanical circulatory support may be lifesaving in patients with right ventricular (RV) failure related to post-cardiotomy cardiogenic chock (PCCS), cardiac transplantation (CTx), and long-term therapy with a left ventricular assist device (LVAD). This study evaluates our clinical experience using the CentriMag (Levitronix LLC, Waltham, Mass) system for temporary mechanical RV support. Methods: A retrospective review was performed of 29 patients (mean age, 57 +/- 14 years) in whom the CentriMag system was used for RV support from September 2005 to March 2008. Results: The indication for RV support was PCCS in 7 (24%), CTx in 10 (35%), and LVAD placement in 12 (41%). The mean support time was 8 +/- 8 days. The device was successfully weaned in 3 PCCS patients (43%), 7 CTx patients (70%), and 7 LVAD patients (58%). Complications included major infection (pneumonia, sepsis, or LVAD pocket infection) in 13 (45%), arrhythmia in 13 (45%), reoperation for bleeding in 10 (35%), stroke/encephalopathy in 3 (10%), and air embolism in 10%). Early mortality (< 30 days or before discharge) occurred in 14 patients (48%) of which 9 (31%) died with the device in place. Late death occurred in 2 of 15 patients (13%) who survived to discharge. There were no device failures. Conclusions: The CentriMag system provides effective temporary mechanical circulatory support for RV failure. Ease of implantation and a high rate of successful device weaning justify, the use of the CentriMag system for temporary RV support. J Heart Lung Transplant 2009;28:971-6. Copyright (C) 2009 by the International Society for Heart and Lung Transplantation.
引用
收藏
页码:971 / 976
页数:6
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