Department of Cardiothoracic Transplantation & Mechanical Support, Royal Brompton and Harefield NHS Foundation Trust, London, UK.
Eur J Cardiothorac Surg. 2013 Nov;44(5):e310-5. doi: 10.1093/ejcts/ezt415. Epub 2013 Aug 29.
Left ventricular assist devices (LVADs) offer very valuable therapeutic options for patients with advanced heart failure. CentriMag (Thoratec, Pleasanton, CA, USA) is an extracorporeal short-term circulatory assist device Conformité Européenne-marked in Europe for use up to 30 days.
Retrospective analysis of 41 patients with advanced heart failure who, from 2003 to 2011, were supported with CentriMag for >30 days as a bridge to recovery, long-term VAD or transplantation.
Forty-one adult patients were supported with 46 CentriMag devices for a total of 2695 days with a mean support time of 59 (range: 31-167) days. Indications were post-cardiotomy cardiogenic shock (PC = 4), primary graft failure (PGF = 7) and refractory heart failure (RHF = 35). Six devices were used to support the left ventricle, 19 to support the right ventricle and 21 to support both the ventricles (biventricular support considered as single device unit). In the PC cohort, 3 (75%) patients were weaned from support, while 4 (57%) were weaned from support in the PGF cohort. In the RHF cohort, 8 patients were bridged to long-term VAD and 5 were bridged to transplantation; heart function recovered and device explanted in 14, while 8 patients died on support. There were no device failures. Overall, 34 (74%) patients were recovered or bridged, with a 1-year survival of 54%.
CentriMag proved to be a versatile, safe and effective short-term circulatory support for patients with advanced heart failure as a bridge to solution. Its use over 30 days is associated with acceptable survival and does not increase device-related complications.
左心室辅助装置（LVAD）为晚期心力衰竭患者提供了非常有价值的治疗选择。CentriMag（美国加利福尼亚州普莱森顿的 Thoratec）是一种体外短期循环辅助装置，在欧洲获得 CE 标志，可用于 30 天以内的治疗。
回顾性分析了 2003 年至 2011 年间，41 例晚期心力衰竭患者使用 CentriMag 超过 30 天作为恢复、长期 VAD 或移植的桥接治疗。
41 例成年患者共使用 46 个 CentriMag 设备支持，总支持时间为 2695 天，平均支持时间为 59（范围：31-167）天。适应证为心脏手术后心源性休克（PC=4）、原发性移植物衰竭（PGF=7）和难治性心力衰竭（RHF=35）。6 个设备用于支持左心室，19 个用于支持右心室，21 个用于支持两个心室（双心室支持视为单个设备单元）。在 PC 组中，3（75%）例患者成功脱机，而 PGF 组中 4（57%）例患者成功脱机。在 RHF 组中，8 例患者桥接至长期 VAD，5 例患者桥接至移植；14 例患者心脏功能恢复并移除设备，8 例患者在支持下死亡。没有设备故障。总体而言，34（74%）例患者得到恢复或桥接，1 年生存率为 54%。
CentriMag 作为一种解决方案的桥接，为晚期心力衰竭患者提供了一种多功能、安全有效的短期循环支持。使用超过 30 天与可接受的生存率相关，并且不会增加与设备相关的并发症。
