Clinical experience using the Levitronix CentriMag system for temporary right ventricular mechanical circulatory support.
BACKGROUND
Short-term mechanical circulatory support may be lifesaving in patients with right ventricular (RV) failure related to post-cardiotomy cardiogenic shock (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 1 (3%). 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.
Bhama
Jay K
JK
Division of Cardiac Surgery, Heart, Lung & Esophageal Surgery Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania 15213, USA. bhamajk@upmc.edu
Kormos
Robert L
RL
Toyoda
Yoshiya
Y
Teuteberg
Jeffrey J
JJ
McCurry
Kenneth R
KR
Siegenthaler
Michael P
MP
D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D001145:Arrhythmias, Cardiac / Q000453:epidemiology; D001775:Blood Circulation; D009202:Cardiomyopathies / Q000145:classification / Q000188:drug therapy / Q000601:surgery; D004867:Equipment Design; D005260:Female; D006353:Heart-Assist Devices / Q000706:statistics & numerical data*; D006801:Humans; D007239:Infections / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018497:Ventricular Dysfunction, Right / Q000150:complications / Q000503:physiopathology* / Q000628:therapy; D014694:Ventricular Outflow Obstruction / Q000150:complications / Q000503:physiopathology* / Q000628:therapy
D000925:Anticoagulants