Short-term mechanical support with the Levitronix CentriMag centrifugal pump

Abstract

Introduction: The CentriMag mechanical support device (Levitronix LLC, Waltham, USA) is intended for short-term paracorporeal circulatory support in patients in refractory cardiogenic shock. The paper presents our experience with the device allowing for urgent initiation of left, right, or biventricular circulatory support. Patients and methods: From December 2007 through December 2010, the CentriMag device was implanted in 20 (3 women) of our patients. The mean age of our patients was 46.5 ± 12.0 years (range, 25-67 years). Indications for device implantation included cardiogenic shock in patients with refractory end-stage heart failure (13 patients with coronary heart disease in seven; dilated cardiomyopathy in four, and myocarditis in two), postcardiotomy heart failure (three), heart transplant failure (three), and right-heart failure following the implantation of the HeartMate II left ventricular assist device (one patient). Results: The mean ventricular support time was 25.3 ± 16.5 days (range, 5-71 days). In seven patients (35%), mechanical support was completed with heart transplantation. Recovery of heart function occurred in five (25%) patients. The HeartMate II long-term left ventricular assist device was implanted in one (5%) patient. Seven (35%) patients died while on the support device. The 30-day and three-month survival rates were 70% (14 patients) and 60% (12 patients), respectively. The mean time from support device implantation to putting the patient on the waiting list was 13.4 ± 20.5 days (range, 0-57 days) depending on recovery of organ (including the CNS) function. The mean waiting time was 14.6 ± 11.3 days (range, 3-35 days). The three-month and one-year survival rates after heart transplantation were 100% and 71% (5 of 7 patients), respectively. Conclusion: The installation of the Levitronix CentriMag device in our center resulted in a marked improvement of an otherwise grim prognosis of patients whose anticipated survival rates, unless undergoing urgent mechanical cardiac support implantation, would be in the order of hours, or several days at most.