Prolonged Use of Levitronix Left Ventricular Assist Device as a Bridge to Heart Transplantation.
A 61-year-old male presented to our emergency room with chest tightness, dyspnea, and cold sweat. He underwent a 12-lead EKG which showed ST-elevation from leads V1-V4 and T wave inversion in leads II, III, and aVF. His troponin-I level was elevated to 70.3 ng/ml. He went into cardiogenic shock when he was in the catheter room. After advanced cardiac life support was administered for 30 min, veno-arterial extracorporeal membrane oxygenation (VA-ECMO) cannulation was set up using 21-french arterial and 21-french venous cannula through the right femoral artery and right femoral vein by the puncture method for hemodynamic support. Subsequently, a coronary artery bypass graft (CABG) for acute myocardial infarction was performed. However, the patient was unable to be weaned from the VA-ECMO. Four days later, a CentriMag (Levitronix LLC, Waltham, MA, USA) left ventricular assist device (LVAD) was applied to avoid ECMO-related complications such as severe hemolysis, ischemic, deteriorated liver and renal function. The patient subsequently underwent a successful orthotopic heart transplant after 87 days on the CentriMag LVAD. The patient was extubated on the next postoperative day and was discharged 2 weeks later.


BACKGROUND
Acute myocardial infarction; Extracorporeal membrane oxygenation; Heart transplantation; Ventricular assist device.
Division of Cardiovascular Surgery, Department of Surgery;
Shih-Ying
SY
Sung
Division of Cardiovascular Surgery, Department of Surgery;
Po-Shun
PS
Hsu
Department of Anesthesia, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Jia-Lin
JL
Chen
Division of Cardiovascular Surgery, Department of Surgery;
Chien-Sung
CS
Tsai
Division of Cardiovascular Surgery, Department of Surgery;
Yi-Ting
YT
Tsai
Division of Cardiovascular Surgery, Department of Surgery;
Chih-Yuan
CY
Lin
Division of Cardiovascular Surgery, Department of Surgery;
Chung-Yi
CY
Lee
Division of Cardiovascular Surgery, Department of Surgery;
Hong-Yan
HY
Ke
Division of Cardiovascular Surgery, Department of Surgery;
Yi-Chang
YC
Lin