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  • Oral presentation
  • Open Access

Thoratec Centrimag VAD for cardiogenic shock – a developing country experience

  • M Villavicencio1Email author,
  • V Rossel1,
  • R Larrea1,
  • J Peralta1,
  • E Larrain1,
  • J Lim1,
  • P Rojo1,
  • E Donoso1,
  • F Gajardo1 and
  • M Hurtado1
Journal of Cardiothoracic Surgery20138(Suppl 1):O156

https://doi.org/10.1186/1749-8090-8-S1-O156

Published: 11 September 2013

Keywords

Cardiogenic ShockNYHA ClassMultiorgan FailureCirculatory SupportSupport Time

Background

Circulatory support is usually not available in developing countries due to cost restrictions. Long-term devices are almost always not affordable for our health system and Thoratec Centrimag® may be an alternative. We report our experience in the treatment of cardiogenic shock with this intermediate-term device.

Methods

Thoratec Centrimag® was used in 22 cardiogenic shock patients. All were INTERMACS class I and all but one had multiorgan failure. Seventeen (77%) were male, mean age 41+13 years. Etiology was ischemic in 11(50%), dilated in 4(22%), and other etiology in 7(32%). Nine (41%) had previous cardiac arrest with a mean arrest time of 18+16 min. Circulatory support was biventricular in 18(82%), univentricular 4(18%), and in 6(27%) an oxygenator was interposed within the outflow line until respiratory recovery. Patients with veno-arterial ECMO configurations were excluded.

Results

Bridge-to-transplant or recovery was obtained in 14 out of 22 (64%). Mean support time 44 days, range 1-292 days. Eight patients (36%) were supported for more than 4 weeks. Thirty-day post-implant survival was 73% (16 patients). Post-implant complications were re-exploration for bleeding 7(32%), neurologic dysfunction 3(14%), pneumonia 8(36%), and renal failure with dialysis in (32%). Eleven (50%) patients are in NYHA class I after a mean follow-up time of 32+6 months. Kaplan Meier one-year survival was 56+11%. Eleven out of 12 (92%) bridged-to-transplant are in NYHA functional class I with normal biventricular function. One patient died 3 days post-transplant due to inflammatory response. Two patients were bridged-to-recovery. One is in NYHA class I and the other died due to non-compliance.

Conclusion

Thoratec Centrimag® is useful to provide intermediate-term circulatory support for cardiogenic shock and multiorgan failure in a developing country. Support time longer than 4 weeks is feasible. A multidisciplinary approach is needed since morbidity is common.

Authors’ Affiliations

(1)
Cardiopulmonary Transplant Service, Instituto Nacional del Tórax, Santiago, Chile

Copyright

© Villavicencio et al; licensee BioMed Central Ltd. 2013

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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