Clinical experience using the Levitronix CentriMag system for temporary right ventricular mechanical circulatory support.

BACKGROUND

Short-term mechanical circulatory support may be lifesaving in patients with right ventricular (RV) failure related to post-cardiotomy cardiogenic shock (PCCS), cardiac transplantation (CTx), and long-term therapy with a left ventricular assist device (LVAD). This study evaluates our clinical experience using the CentriMag (Levitronix LLC, Waltham, Mass) system for temporary mechanical RV support.

METHODS

A retrospective review was performed of 29 patients (mean age, 57 +/- 14 years) in whom the CentriMag system was used for RV support from September 2005 to March 2008.

RESULTS

The indication for RV support was PCCS in 7 (24%), CTx in 10 (35%), and LVAD placement in 12 (41%). The mean support time was 8 +/- 8 days. The device was successfully weaned in 3 PCCS patients (43%), 7 CTx patients (70%), and 7 LVAD patients (58%). Complications included major infection (pneumonia, sepsis, or LVAD pocket infection) in 13 (45%), arrhythmia in 13 (45%), reoperation for bleeding in 10 (35%), stroke/encephalopathy in 3 (10%), and air embolism in 1 (3%). Early mortality (< 30 days or before discharge) occurred in 14 patients (48%) of which 9 (31%) died with the device in place. Late death occurred in 2 of 15 patients (13%) who survived to discharge. There were no device failures.

CONCLUSIONS

The CentriMag system provides effective temporary mechanical circulatory support for RV failure. Ease of implantation and a high rate of successful device weaning justify the use of the CentriMag system for temporary RV support.