Levitronix

OBJECTIVES: 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. METHODS: 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...

The Levitronix CentriMag is approved in Europe for 30 days as uni- or biventricular support in acute heart failure as a bridge to recovery, bridge to heart transplantation or to a long-term left ventricular assist device (LVAD). We report the case of a patient who was supported with the same Levitronix CentriMag pump for 119 days without changing any components of the circuit or the pump head because of an anatomical condition which precluded the feasibility of pump exchange and who did not experience any mechanical failure of the impeller but eventually died due to the rupture of the cannulae...

The left ventricular assist device may be a lifesaving therapy for a patient awaiting a heart transplant. The most common complications of this device are mediastinal bleeding, infections, embolic events, right-sided heart failure, and mediastinal adhesions. We are reporting a patient who had a Levitronix left ventricular assist device implanted with mini-pericardiotomy technique for bridging to heart transplant.

A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was: is extracorporeal membrane oxygenation (ECMO) superior to dedicated ventricular assist device (VAD) in patients with acutely failing allograft following transplantation. Altogether, 162 papers were found using the reported search, of which 8 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated...

Fulminant myocarditis (FM) represents a crucial cardiac pathology with extensive hemodynamic compromise occurring in a previously healthy patient. Early death occurs because of acute cardiac decompensation from inflammation, necrosis, and myocytolysis. Nevertheless, in this situation implantation of an extracorporeal circulatory support system may ensure cardiac recovery. We herein report our experience using a biventricular Levitronix CentriMag system for bridge to recovery.

BACKGROUND: The use of short-term ventricular assist devices (VAD) in patients awaiting high-urgency (HU) heart transplantation (HTx) in Spain has steadily increased due to longer waiting times and the new heart allocation system. It is unknown whether the use of short-term VAD support in patients with cardiogenic shock affects HTx outcome. We sought to investigate long-term outcomes of HU transplanted patients with VAD compared with HU transplanted patients without device support. METHODS: We retrospectively evaluated all HTx patients transplanted between 1999 and 2011 in our institution...

BACKGROUND: The CentriMag ventricular assist device (VAD) has gained popularity in the last several years as rescue support for patients with decompensated heart failure. We have used the CentriMag VAD as a bridge to decision device. We describe our experience with device placement, use and outcomes. METHODS: This is a retrospective study of all patients who underwent CentriMag placement at our institution from January 2007 to August 2009. Sixty-three patients had placement of a CentriMag device, with 43% (n = 27) of these being placed due to failure of medical management...

An otherwise healthy 47-year-old man presented to the emergency department in cardiogenic shock after suffering a massive myocardial infarction due to left main occlusion. He was initially supported by extracorporeal membrane oxygenation and subsequently was converted to paracorporeal support with a Levitronix left ventricular assist device. He experienced multiple postoperative complications including renal failure, respiratory failure, retroperitoneal hematoma requiring suspension of anticoagulation, and fungal bloodstream infection precluding transition to an implantable device...

Ventricular assist device (VAD) therapy has been used successfully as a bridge to recovery, bridge to transplant and in the last decade as a destination therapy. The use of VAD for post-cardiotomy cardiogenic shock (PCCS) is not currently reported in national databases in the UK and Ireland. Data were collected through a telephone survey of chief perfusionists from all the cardiac surgery units in the UK and Ireland between October 2007 and October 2008. Approximately 28 000 adult cardiac surgical procedures were performed at 45 cardiac centres, of which 33 (73%) reported using VAD...

BACKGROUND: Risk assessment prior to long-term ventricular assist device (VAD) placement has been shown to be crucial for successful outcomes and efficient resource utilization. Short-term VADs are often used as salvage therapy in acute heart failure when the clinical scenario precludes such thorough preoperative assessment. Our goal was to devise a risk stratification system that may be used shortly after stabilization of hemodynamics with a short-term VAD to predict the likelihood of survival...

Right ventricular failure (RVF) following implantation of a left ventricular assist system (LVAS) is associated with high morbidity and mortality.( 1-4 ) Numerous centers have reported short-term use of the CentriMag (®) Ventricular Assist System (CVAS) (Levitronix LLC, Waltham, MA) for treatment of cardiogenic shock, decompensated heart failure and right ventricular failure (RVF) following LVAS implantation.( 5-9 ) The present report reviews the clinical course of a patient requiring long-term right ventricular support utilizing the CVAS, following a HeartMate (®) II LVAS (Thoratec Corp...

Extracorporeal membrane oxygenation (ECMO) is a lifesaving therapy, which has been used for the support of children with a broad range of diseases. Two pumps of differing mechanisms have been used to generate the extracorporeal flow: roller-head pumps and centrifugal pumps. Seven patients supported during ECMO with Levitronix Centrimag (Centrimag group [CG]) were matched to 14 patients supported with Stockert-Shiley SIII (Stockert-Shiley group [SSG]) at a single institution from July 2007 to July 2009. We hypothesized that hemolysis as measured by plasma-free hemoglobin (PFH) is elevated in the SSG versus the CG during cardiac ECMO...

The Levitronix CentriMag (Levitronix LLC, Waltham, MA) ventricular assist device (VAD) is a magnetically levitated rotary pump designed for temporary extracorporeal support. Between February 2004 and May 2010, 42 consecutive adult patients were supported with Levitronix at our institution (32 men; age 62.3 ± 10.5 years, range: 31-76 years). Indications for support were (group A, n = 37) failure to wean from the cardiopulmonary bypass in the setting of postcardiotomy (n = 23), primary donor graft failure (n = 4), or right ventricular failure after axial left VAD (LVAD) placement (n = 10) and (group B, n = 5) refractory heart failure after acute myocardial infarction...

OBJECTIVE: Primary graft failure is the most common cause of mortality early after heart transplantation. The availability of relatively low-cost short-term mechanical support devices has altered the management of primary graft failure but there are few data on clinical outcome. Here, we describe the UK experience with Levitronix CentriMag support following heart transplantation across multiple centres. METHODS: Data for all adult heart transplants and all CentriMag devices used within 30 days of heart transplantation in the UK between November 2003 and July 2008 were collected...

Severe 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...

The use of short-term mechanical circulatory support during postcardiotomy acute heart failure provides an opportunity to stabilize the patient's hemodynamic state while determining the best long-term strategy. Because all of these devices require anticoagulation treatment of various intensities, management of major bleeding can be critical for the overall outcome of the therapy. In this regard, the newest generation of magnetically levitated centrifugal-flow pumps affords several potential advantages in terms of thrombogenicity and eventual discontinuation of anticoagulation treatment...

Cardiogenic shock after percutaneous coronary intervention (PCI) is a life-threatening complication and is most often related to abrupt vessel closure. We present the case of a patient who developed cardiogenic shock after PCI and was supported with intra-aortic balloon counterpulsation and the Levitronix CentriMag short-term mechanical circulatory support. He was evaluated for implantation of a ventricular assist device as bridge-to-transplantation. Preoperative transesophageal echocardiography revealed a massive thrombus of the aortic root and ascending aorta despite optimal anticoagulation regimen...

OBJECTIVE: The Levitronix CentriMag (Levitronix LLC, Waltham, Mass) ventricular assist system is designed for temporary left, right, or biventricular support. Advantages include ease of use, excellent reliability, and low thrombosis risk,. which may allow wider application of short-term support and improved outcomes in patients with cardiogenic shock. This multi-institutional study evaluated safety, effectiveness, and outcomes of the CentriMag in patients with cardiogenic shock. METHODS: Thirty-eight patients were supported at 7 centers...

Despite the many advances in the management of patients with acute heart failure, the outcome for patients with refractory acute cardiogenic shock remains disproportionately poor. Clearly, there is a definitive role for wider application of temporary circulatory support in such patients. Questions remain as to the ideal device, the optimal duration of temporary support, and the ideal timing to bridge these patients to a long-term device. There are currently several options available for circulatory support and include surgically implanted ventricular assist devices, percutaneous assist devices, and extracorporeal membrane oxygenation...

BACKGROUND: Cardiogenic shock refractory to conventional therapy has very high mortality and limited support options. New technology with peripherally inserted CentriMag (Levitronix LLC, Waltham, MA) extracorporal membrane oxygenation (ECMO) may have the potential to significantly improve survival in these critically ill patients. Outcomes of the first 10 patients to receive this device at our institutions are presented. METHODS: Patients were identified by their primary physicians and evaluated by our Mechanical Circulatory Support Team...