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The Journal of Heart and Lung Transplantation
International Society for Heart and Lung Transplantation.
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Original clinical science| Volume 31, ISSUE 6, P611-617, June 2012

The CentriMag ventricular assist device in acute heart failure refractory to medical management

DOI:https://doi.org/10.1016/j.healun.2011.12.016
The CentriMag ventricular assist device in acute heart failure refractory to medical management
Previous ArticleLiver dysfunction as a predictor of outcomes in patients with advanced heart failure requiring ventricular assist device support: Use of the Model of End-stage Liver Disease (MELD) and MELD eXcluding INR (MELD-XI) scoring system
Next ArticleBridging cardiogenic shock patients with short-term ventricular support at a community hospital to long-term ventricular support at a tertiary hospital

      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/m2, 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.

      Keywords

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      Article info

      Identification

      DOI: https://doi.org/10.1016/j.healun.2011.12.016

      Copyright

      © 2012 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

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