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J Heart Lung Transplant. 2012 Jun;31(6):611-7. doi: 10.1016/j.healun.2011.12.016.

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

Author information

1
Division of Cardiothoracic Surgery, Columbia University Medical Center, 1330 First Avenue #607, New York, NY 10021, USA. bmworku@hotmail.com

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.

PMID:
22608770
DOI:
10.1016/j.healun.2011.12.016
[Indexed for MEDLINE]
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