Levitronix CentriMag short-term ventricular assist device as a „bridge-to-bridge“ solution

Abstract

Introduction: Levitronix CentriMag is a novel extracorporeal magnetically levitated centrifugal blood pump designed for short-term mechanical circulatory support (MCS). The device, combined with BerlinHeart cannulas, can later be exchanged for a long-term BerlinHeart Excor device, if patients remain without myocardial recovery despite peripheral organ recovery. We reviewed our experience with this strategy. Methods: Inflow and outflow Berlin Heart cannulas were placed in traditional fashion. Titanium connectors were introduced between the cannulas and Levitronix circuit. Pump exchange was performed, without resternotomy, in the intensive care unit or operating room with the patient slightly sedated. Results: Between 12/2006 and 07/2007, 14 patients (13 men; age 50.2±16.1, range:24–73 years), out of an overall population of 39 consecutive cases supported with Levitronix at our institution, were judged to be candidates for BerlinHeart Excor. In 10 cases MCS was established in a biventricular,in 2 in a left ventricular and in 2 in a right ventricular configuration. Indications for primary support at implantation were: postcardiotomy cardiogenic shock (n=5) and bridge to decision regarding transplantation or permanent support (n=9) (7 dilated cardiomyopathy, 1 fulminant myocarditis, 1 acute myocardial infarction). The conversion to long-term device was performed after 7.4±3.8 (range: 1–16) days. One patient received successful transplantation. Eleven patients were discharged home and three of them are currently waiting for a suitable organ. One patient is on biventricular support as permanent solution. Two patients died of sepsis. At the latest follow-up, mean duration of support is 112.4±78 (range:10–210) days. Conclusions: Levitronix has proved useful and enabled patients to be bridged to long-term support. The exchange for Berlin Heart pumps produces good results, avoiding the risks of repeated sternotomy and reducing the costs involved.