Levitronix CentriMag Pump as Perioperative Left Ventricular Support in a Patient with Critical Aortic Stenosis, Mitral Regurgitation, and Cardiogenic Shock
AbstractSevere aortic stenosis (AS) has a poor prognosis when associated with left ventricular dysfunction and congestive heart failure. Despite a relatively high operative mortality, most patients with severe AS and a depressed left ventricular ejection fraction (LVEF) should be considered candidates for aortic valve replacement. The CentriMag left ventricular assist system (Levitronix) can be used for perioperative or postcardiotomy circulatory support for the failing heart. In this case report, we report the successful use of the Levitronix CentriMag device as perioperative support in a high-risk patient with severe AS, significant mitral insufficiency, and a poor LVEF with advanced organ failure.
Connolly HM, Oh JK, Orszulak TA, et al. 1997. Aortic valve replacement for aortic stenosis with severe left ventricular dysfunction: prognostic indicators. Circulation 95:2395-400.nConnolly HM, Oh JK, Schaff HV, et al. 2000. Severe aortic stenosis with low transvalvular gradient and severe left ventricular dysfunction: result of aortic valve replacement in 52 patients. Circulation 101:1940-6.nGrossi EA, Schwartz CHF, Yu P, et al. 2008. High-risk aortic valve replacement: are the outcomes as bad as predicted? Ann Thorac Surg 85:102-7.nHalkos ME, Chen EP, Sarin EL, et al. 2009. Aortic valve replacement for aortic stenosis in patients with left ventricular dysfunction. Ann Thorac Surg 88:746-51.nJohn R, Liao K, Lietz K, et al. 2007. Experience with the Levitronix CentriMag circulatory support system as a bridge to decision in patients with refractory acute cardiogenic shock and multisystem organ failure. J Thorac Cardiovasc Surg 134:351-8.nLund O, Flø C, Jensen FT, et al. 1997. Left ventricular systolic and diastolic function in aortic stenosis. Prognostic value after valve replacement and underlying mechanisms. Eur Heart J 18:1977-87.nVánky FB, Håkanson E, Tamáart failure in patients operated on for aortic stenosis. Ann Thorac Surg 81:1297-304.n