We report our experience with the Levitronix CentriMag (Levitronix LLC, Waltham, MA) in the setting of venoarterial extracorporeal membrane oxygenation (ECMO) system support as treatment for postcardiotomy cardiogenic shock. Between January 2007 and August 2011, 14 consecutive adult patients received CentriMag ECMO support after cardiac surgery procedures at our institution. There were nine males (64.3%) and the mean age was 53.1 ± 14.3 years (range: 25-70 years). Cardiac surgery included: n = 6, aortic and/or mitral valve replacement; n = 5, coronary artery bypass grafting (CABG); and n = 3, Bentall procedures. The CentriMag ECMO support was installed centrally in eight patients and peripherally in six. Median duration of support was 5 days (range: 1-55 days). Seven patients were weaned from ECMO (50%), whereas six patients died while on support mainly because of multiple organ failure (42.9%). One patient died on ECMO support after transfer to the referral hub center while waiting for heart transplantation (Htx). Six (42.8%) patients were successfully discharged home. Levitronix CentriMag in ECMO configuration proved to be effective in managing postcardiotomy cardiogenic shock and the results are encouraging. The system was easy to install and manage.
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http://dx.doi.org/10.1097/MAT.0b013e3182768b68 | DOI Listing |
Front Cardiovasc Med
December 2024
Department of Cardiac Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China.
Background: Acute type A aortic dissection (ATAAD) poses significant challenges in cardiovascular management due to its high morbidity and mortality rates. Postcardiotomy cardiogenic shock (PCS) is a severe complication following ATAAD repair that complicates postoperative recovery. Extracorporeal membrane oxygenation (ECMO) has emerged as a potential life-saving intervention in this context, yet the specific outcomes related to ECMO in ATAAD patients remain insufficiently studied.
View Article and Find Full Text PDFJ Clin Med
November 2024
Department of Thoracic and Cardiovascular Surgery, West German Heart and Vascular Center, Hufelandstrasse 55, 45147 Essen, Germany.
: Coronary artery bypass surgery (CABG) with multiple arterial grafting (MAG) has shown potential to improve patient survival compared to single arterial bypass grafting. Whether this superiority in survival also exists in diabetics is uncertain. We therefore aimed to compare short and long-term outcomes of MAG in diabetic versus non-diabetic patients.
View Article and Find Full Text PDFInterdiscip Cardiovasc Thorac Surg
December 2024
Department of Cardiovascular Surgery, Kanazawa University, Kanazawa, Japan.
Patients with low-flow, low-gradient severe aortic stenosis and ischaemic cardiomyopathy are at risk for postcardiotomy cardiogenic shock and have a poor prognosis. Although Impella has emerged as a bridge therapy, traditional approaches for Impella insertion are infeasible in patients with peripheral vascular diseases. We successfully managed postcardiotomy cardiogenic shock in a patient with low-flow, low-gradient severe aortic stenosis and ischaemic cardiomyopathy and limited vascular access by introducing Impella via the brachiocephalic artery.
View Article and Find Full Text PDFExpert Rev Med Devices
December 2024
Department of Cardiothoracic and Vascular Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
Introduction: The Impella 5.5 device is a surgically inserted, trans-valvular, microaxial flow device capable of providing 5.5 L/min of continuous, antegrade flow from the left ventricle (LV) to the aorta.
View Article and Find Full Text PDFJ Clin Med
November 2024
Heart and Vascular Institute, Pennsylvania State Milton S Hershey Medical Center, Hershey, PA 17033, USA.
: Patients in cardiogenic shock (CS) may be successfully bridged using intravascular micro-axial left ventricular assist devices (M-LVADs) for recovery or determination of definitive therapy. : One hundred and seven CS patients implanted with M-LVADs from January 2020 to May 2024 were divided into four groups; group-1: 34 patients (transplant); group-2: 25 patients (LVAD); group-3: 42 patients (postcardiotomy CS (PCCS)); group-4: 6 patients (decision/recovery but excluded from analysis). Multivariable logistic regression and Multivariable Coxregression models identified predictors of early -hospital and late mortality, and Odds ratios (ORs) and hazard ratios (HRs) with < 0.
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