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

被引:88
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
相关论文
共 18 条
[1]   Experience with right ventricular assist devices for perioperative right sided circulatory failure [J].
Chen, JM ;
Levin, HR ;
Rose, EA ;
Addonizio, LJ ;
Landry, DW ;
Sistino, JJ ;
Michler, RE ;
Oz, MC .
ANNALS OF THORACIC SURGERY, 1996, 61 (01) :305-310
[2]   Levitronix ventricular assist device as a bridge-to-recovery for post-cardiotomy cardiogenic shock [J].
Clough, Rachel E. ;
Vallely, Michael P. ;
Henein, Michael Y. ;
Pepper, John R. .
INTERNATIONAL JOURNAL OF CARDIOLOGY, 2009, 134 (03) :408-409
[3]  
Dang NC, 2006, J HEART LUNG TRANSPL, V25, P1, DOI 10.1016/j.healun.2005.07.008
[4]   Clinical performance with the levitronix centrimag short-term ventricular assist device [J].
De Robertis, F ;
Birks, EJ ;
Rogers, P ;
Dreyfus, G ;
Pepper, JR ;
Khaghani, A .
JOURNAL OF HEART AND LUNG TRANSPLANTATION, 2006, 25 (02) :181-186
[5]   Bridge to decision using the levitronix CentriMag short-term ventricular assist device [J].
De Robertis, Fabio ;
Rogers, Paula ;
Amrani, Mohammed ;
Petrou, Mario ;
Pepper, John R. ;
Bahrami, Toufan ;
Dreyfus, Gilles D. ;
Khaghani, Asghar ;
Birks, Emma J. .
JOURNAL OF HEART AND LUNG TRANSPLANTATION, 2008, 27 (05) :474-478
[6]   Preoperative and postoperative comparison of patients with univentricular and biventricular support with the Thoratec ventricular assist device as a bridge to cardiac transplantation [J].
Farrar, DJ ;
Hill, JD ;
Pennington, DG ;
McBride, LR ;
Holman, WL ;
Kormos, RL ;
Esmore, D ;
Gray, LA ;
Seifert, PE ;
Schoettle, GP ;
Moore, CH ;
Hendry, PJ ;
Bhayana, JN .
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 1997, 113 (01) :202-209
[7]  
Gregoric ID, 2008, TEX HEART I J, V35, P184
[8]   Standard criteria for an acceptable donor heart are restricting heart transplantation [J].
Jeevanandam, V ;
Furukawa, S ;
Prendergast, TW ;
Todd, BA ;
Eisen, HJ ;
McClurken, JB .
ANNALS OF THORACIC SURGERY, 1996, 62 (05) :1268-1275
[9]   Experience with the Levitronix CentriMag circulatory support system as a bridge to decision in patients with refractory acute cardiogenic shock and multisystem organ failure [J].
John, Ranjit ;
Liao, Kenneth ;
Lietz, Katherine ;
Kamdar, Forum ;
Colvin-Adams, Monica ;
Boyle, Andrew ;
Miller, Leslie ;
Joyce, Lyle .
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 2007, 134 (02) :351-358
[10]   INTERMACS database for durable devices for circulatory support: First annual report [J].
Kirklin, James K. ;
Naftel, David C. ;
Stevenson, Lynne Warner ;
Kormos, Robert L. ;
Pagani, Francis D. ;
Miller, Marissa A. ;
Ulisney, Karen ;
Young, James B. .
JOURNAL OF HEART AND LUNG TRANSPLANTATION, 2008, 27 (10) :1065-1072