title: The CentriMag ventricular assist device in acute heart failure refractory to medical management.
abstract: BACKGROUND
  The CentriMag ventricular assist device (VAD) has gained popularity in the last several years as rescue support for patients with decompensated heart failure. We have used the CentriMag VAD as a bridge to decision device. We describe our experience with device placement, use and outcomes.
  
  
  METHODS
  This is a retrospective study of all patients who underwent CentriMag placement at our institution from January 2007 to August 2009. Sixty-three patients had placement of a CentriMag device, with 43% (n = 27) of these being placed due to failure of medical management. These cases were the focus of our study.
  
  
  RESULTS
  Primary diagnoses were ischemic cardiomyopathy (n = 17), dilated cardiomyopathy (n = 7) or other (n = 3). Mean age was 47.1 (range 7 to 72) years. Prior to implant, 85% of patients were on intra-aortic balloon pump (IABP) support, 70% were on vasopressors, and 44% were on more than one inotrope. INTERMACS score was 1 in 67% of patients and 2 in 33% of patients. Six patients were bridged to a long-term device, 8 to transplantation and 10 to recovery. Eighty-nine percent (24 of 27) of patients survived to explant and 74% (20 of 27) survived to hospital discharge, with a 1-year survival of 68%. Thromboembolic complications occurred in 10 patients, including 6 strokes. Compared with patients who survived to discharge, those who died had a significantly higher body mass index (30.8 vs 24.1 kg/m(2), p = 0.003). Survivors to discharge demonstrated significant improvements in hepatic and renal function over the course of device support while non-survivors did not.
  
  
  CONCLUSIONS
  The CentriMag demonstrates promising results when used in patients with acute heart failure refractory to medical management.
authors.affiliation: Division of Cardiothoracic Surgery, Columbia University Medical Center, 1330 First Avenue #607, New York, NY 10021, USA. bmworku@hotmail.com
authors.forename: Berhane
authors.initials: B
authors.lastname: Worku
authors.forename: Sang-Woo
authors.initials: SW
authors.lastname: Pak
authors.forename: Danielle
authors.initials: D
authors.lastname: van Patten
authors.forename: Brian
authors.initials: B
authors.lastname: Housman
authors.forename: Nir
authors.initials: N
authors.lastname: Uriel
authors.forename: Paolo
authors.initials: P
authors.lastname: Colombo
authors.forename: Ulrich
authors.initials: U
authors.lastname: Jorde
authors.forename: Hiroo
authors.initials: H
authors.lastname: Takayama
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Naka
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D015331:Cohort Studies; D019468:Disease Management; D006333:Heart Failure / Q000150:complications / Q000401:mortality* / Q000628:therapy*; D006353:Heart-Assist Devices; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016879:Salvage Therapy; D020521:Stroke / Q000453:epidemiology; D015996:Survival Rate; D013923:Thromboembolism / Q000453:epidemiology; D016896:Treatment Outcome; D055815:Young Adult