TY - JOUR
T1 - The CentriMag ventricular assist device in acute heart failure refractory to medical management
AU - Worku, Berhane
AU - Pak, Sang Woo
AU - Van Patten, Danielle
AU - Housman, Brian
AU - Uriel, Nir
AU - Colombo, Paolo
AU - Jorde, Ulrich
AU - Takayama, Hiroo
AU - Naka, Yoshifumi
N1 - Copyright:
Copyright 2013 Elsevier B.V., All rights reserved.
PY - 2012/6
Y1 - 2012/6
N2 - 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.
AB - 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.
KW - BIVAD
KW - cardiogenic shock
KW - heart failure
KW - mechanical circulatory support
KW - medical management of shock
UR - http://www.scopus.com/inward/record.url?scp=84861130017&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84861130017&partnerID=8YFLogxK
U2 - 10.1016/j.healun.2011.12.016
DO - 10.1016/j.healun.2011.12.016
M3 - Article
C2 - 22608770
AN - SCOPUS:84861130017
VL - 31
SP - 611
EP - 617
JO - Journal of Heart and Lung Transplantation
JF - Journal of Heart and Lung Transplantation
SN - 1053-2498
IS - 6
ER -