Abstract 296: Intermediate Clinical Performance of the Levitronix CentriMag Ventricular Assist Device in Supporting Cardiogenic Shock Patients
Background: The early mortality rate in cardiogenic shock patients approaches 50% despite aggressive medical therapy. There is lack of intermediate ventricular assist device (VAD) support for this group of patients. Levitronix CentriMag VAD (Levitronix VAD) is a centrifugal pump approved by FDA for postcardiotomy circulatory support in cardiogenic shock patients. Little is known about its intermediate clinical performance. We report our experience with this device in cardiogenic shock patients supported for longer than one week.
Methods: Between January 2004 and February 2008, 35 patients with cardiogenic shock who failed maximal medical therapy and were initially considered non-suitable for long-term implantable VAD support (mean age, 49.5±13.4 years; range 19 to 75 years; 21 males) were supported with Levitronix VAD for 7 or more days. The etiology of cardiogenic shock included idiopathic (n=9); post-cardiotomy (n=8); acute myocardial infarction (n=7); graft failure after heart transplantation (n=6); right heart failure after recent implantable LVAD implantation (n=3) and acute cor pulmonale (n=2). Twenty bilateral, 13 right and 2 left Levitronix VADs were implanted. Intravenous heparin was used for device anticoagulation.
Results: The mean Levitronix VAD support time for all patients was 13.3 ± 5.8 days (range 7 to 31). Seven patients died while on Levitronix VAD support while16 patients had the device explanted after improved cardiac function. Twelve patients were bridged to long-term Levitronix VAD support. The 30-day overall mortality rate was 29% (n=10). Atrial clots around the Levitronix VAD cannulae were found in 6 patients. The device was exchanged in 4 patients due to thrombosis. Four patients suffered stroke while being supported. There was no mechanical failure of the device.
Conclusions: Levitronix VAD support exceeding one week appears effective in treating cardiogenic shock. The early mortality of Levitronix VAD supported patients was lower when compared to the historical controls of medical therapy. Survival to explant or to a long-term implantable VAD was encouraging in this group of high risk patients who were previously considered non-suitable for a long-term implantable VAD support.
- © 2010 by American Heart Association, Inc.