title: Comprehensive management of severe intestinal bleeding in a patient supported for 94 days by the biventricular Levitronix CentriMag system.
abstract: The use of short-term mechanical circulatory support during postcardiotomy acute heart failure provides an opportunity to stabilize the patient's hemodynamic state while determining the best long-term strategy. Because all of these devices require anticoagulation treatment of various intensities, management of major bleeding can be critical for the overall outcome of the therapy. In this regard, the newest generation of magnetically levitated centrifugal-flow pumps affords several potential advantages in terms of thrombogenicity and eventual discontinuation of anticoagulation treatment. We report the use of a short-term biventricular assist device (Levitronix CentriMag) for 94 days in a 55-year-old man with refractory ventricular arrhythmias after combined heart surgery. Despite serious complications while the patient was on the assist device, including severe intestinal bleeding with the necessity of discontinuing anticoagulation for 10 days and, ultimately, hemicolectomy, the circulatory support was completed with successful heart transplantation.
authors.affiliation: Department of Cardiac Surgery, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
authors.forename: Ivan
authors.initials: I
authors.lastname: Netuka
authors.forename: Ondrej
authors.initials: O
authors.lastname: Szarszoi
authors.forename: Jiri
authors.initials: J
authors.lastname: Maly
authors.forename: Marek
authors.initials: M
authors.lastname: Adamira
authors.forename: Daniel
authors.initials: D
authors.lastname: Turek
authors.forename: Josef
authors.initials: J
authors.lastname: Besik
authors.forename: Marian
authors.initials: M
authors.lastname: Urban
authors.forename: Hynek
authors.initials: H
authors.lastname: Riha
authors.forename: Tomas
authors.initials: T
authors.lastname: Kotulak
authors.forename: Jan
authors.initials: J
authors.lastname: Pirk
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use*; D006471:Gastrointestinal Hemorrhage / Q000150:complications / Q000188:drug therapy*; D006333:Heart Failure / Q000150:complications* / Q000628:therapy*; D006353:Heart-Assist Devices; D006801:Humans; D007410:Intestinal Diseases / Q000150:complications / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged
chemical_list: D000925:Anticoagulants