Thorac Cardiovasc Surg 2014; 62 - SC110
DOI: 10.1055/s-0034-1367371

CentriMag short-term ventricular assist device as a bridge to decision in post-cardiotomy cardiogenic shock

A. Sabashnikov 1, P.N. Mohite 1, A.-F. Popov 1, J. Fatullayev 1, D. García Sáez 1, N.P. Patil 1, B. Zych 1, F. De Robertis 1, M. Amrani 1, T. Bahrami 1, A.R. Simon 1
  • 1Royal Brompton & Harefield NHS Foundation Trust, Department of Cardiothoracic Transplantation and Mechanical Circulatory Support, Harefield, London, United Kingdom

Introduction: The CentriMag® (Levitronix LLC, Waltham, Mass) system is an extra corporeal short term circulatory assist device which offers very valuable therapeutic options in PCCS as a bridge to decision. Post-Cardiotomy Cardiogenic Shock (PCCS) is observed in patients having surgery under cardiopulmonary bypass, most commonly as a result of myocardial stunning or hibernation. It occurs in 2-6% of all cardiac surgical procedures. Most of the cases respond to conventional pharmacological and mechanical support, i.e. intra-aortic balloon pump; however, there are cases in which myocardial recovery is refractory to these measures and would require additional mechanical support. This patient population has nearly 100% mortality unless treated by mechanical support, which offers the only hope of survival.

Methods: A retrospective review was performed in 28 patients who were treated with CentriMag® short term VAD as bridge to decision between years 2004 and 2011. CentriMag is a single-use extracorporeal centrifugal blood pump based on bearing-less motor technology. The motor generates the magnetic bearing force that levitates the rotor in the pump housing and, at the same time, generates the torque to produce the unidirectional flow up to 10 L/min.

Results: Between 2004 and 2011, 125 adult patients were supported with 140 Levitronix devices at our institute. Twenty-eight out of them were used to treat PCCS. Left ventricle was supported in 18 (LVAD); right ventricle was supported in 3 (RVAD), while both the ventricles were supported in 10 cases (BiVAD). The total support duration was 329 days. The mean support time was 11.75 ± 16.01 days (range: 1-65 days). 16 (57.14%) patients died on support, 12 (42.85%) patients were weaned from support while 8 (28.57%) were actually discharged home. One patient on Levitronix LVAD was converted to Levitronix BIVAD while another was converted to Long term VAD. Of the 72 (51.42%) patients who recovered and were discharged home, 45 (36%) are presently alive. There were no device failures.

Conclusion: The Levitronix CentriMag has proven to be a versatile, safe and effective short-term circulatory support for patients with post-cardiotomy cardiogenic shock as a bridge to decision.