Asistencia ventricular mecánica como puente al trasplante en pacientes en shock cardiogénico: Experiencia preliminar en Chile con ABIOMED BVS 5000®

unclassified

Primer puente a trasplante cardiaco exitoso en Chile usando el dispositivo Heart Mate II

Bunster¹,

Villavicencio

Lim³

et al. 2014

“…Cuando se han agotado las posibilidades terapéuticas con drogas vasoactivas, inhibidores de fosfodiesterasa III, vasodilatadores pulmonares específicos como prostaglandinas y óxido nítrico, es vital recurrir al uso de asistencia ventricular mecánica [1][2][3][4][5] .…”

unclassified

Asistencia ventricular derecha con bomba centrífuga

Pedemonte

Santander

et al. 2008

Acute right ventricular failure after cardiac surgery occurring in the first postoperative hours is associated with a bad prognosis. We have used a centrifugal pump either for left, right or biventricular assistance. However, the use of this device for pure right ventricular assistance is rare. We report a 30 year-old female undergoing a mitral valve replacement and a 42 year-old male undergoing a cardiac transplantation, who had a successful right ventricular assistance using a centrifugal pump, due to a failing right ventricle, as the result of insufficient myocardial protection and severe pulmonary hypertension. These two cases illustrate the value of the mechanical ventricular assist device for the treatment of right heart failure (Rev Méd Chile 2008; 136: 359-66). (

Puente al trasplante de 4 semanas utilizando el sistema de asistencia ventricular Levitronix Centrimag® en el shock cardiogénico post-infarto al miocardio: Caso clínico

Villavicencio¹,

Larrea²,

Larraín³

et al. 2010

Cardiogenic shock after myocardial infarction has a high mortality even if early revascularization is achieved. Biventricular assist devices have not been used in Chile in this critical setting. We report a case of a 55-year-old diabetic man who suffered an acute chest pain and ventricular fibrillation. Prompt outside hospital defibrillation/reanimation restored pulse and allowed emergency room transfer on mechanical ventilation. Electrocardiogram showed an anterior myocardial infarction and early revascularization was achieved by anterior descending artery angioplasty. However, severe cardiogenic shock continued in spite of inotropic and intra aortic balloon pump support. Levitronix Centrimag biventricular mechanical circulatory support was inserted during reanimation for recurrent ventricular fibrillation and the patient listed for urgent cardiac transplantation upon stabilization. Heart transplantation was performed successfully 28 days later and the patient was discharged after a 21-day recovery period. Twelve months after transplant the patient is in NYHA functional class I with normal biventricular function. Levitronix Centrimag biventricular mechanical circulatory support could be used successfully as a bridge-to-transplant for myocardial infarction cardiogenic shock.