Thoratec CentriMag for Temporary Treatment of Refractory Cardiogenic Shock or Severe Cardiopulmonary Insufficiency

Borisenko, Oleg; Wylie, Gillian; Payne, John; Bjessmo, Staffan; Smith, Jon; Yonan, Nizar; Firmin, Richard K.

doi:10.1097/mat.0000000000000117

Cited by 83 publications

(53 citation statements)

References 48 publications

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“…The incidence of EGF has increased slightly in recent years, probably due to the shortage of organs and the consequent extensive use of marginal donors with high α‐agonist or inotropic dosages . Reported rates of EGF after Htx range from 2.3 to 28.2%, with mortality rates ranging from 20 to 66% , which is in line with our data.…”

Section: Discussionsupporting

confidence: 89%

“…The incidence of EGF has increased slightly in recent years, probably due to the shortage of organs and the consequent extensive use of mar-ginal donors with high a-agonist or inotropic dosages (1,2). Reported rates of EGF after Htx range from 2.3 to 28.2%, with mortality rates ranging from 20 to 66% (1)(2)(3)(4)(5)(6)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24), which is in line with our data. Such a wide range of incidence represents wide ranges in definitions and types of treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Short-term use of VAD and ECMO systems in the treatment of EGF has been described extensively (11)(12)(13)(14)(15)(16), with different approaches determined mainly by the centers' expertise. At present, ECMO is widely accepted for postcardiotomy and EGF, given the easier and faster setup, versatility, optimal end-organ perfusion, and the ability to provide biventricular and lung assistance, with a single costless pump.…”

Section: Discussionmentioning

confidence: 99%

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Role of Intra‐Aortic Balloon Pump and Extracorporeal Membrane Oxygenation in Early Graft Failure After Cardiac Transplantation

Loforte¹,

Murana²,

Cefarelli³

et al. 2016

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Early graft failure (EGF) is a major risk factor for death after heart transplantation (Htx). We investigated the predictive risk factors for moderate-to-severe EGF requiring an intra-aortic balloon pump (IABP) or extracorporeal membrane oxygenation (ECMO) circulatory support as treatment after Htx. Between January 2000 and December 2014, 412 consecutive adult patients underwent isolated Htx at our institution. Moderate and severe EGF were defined as the need for IABP and ECMO support, respectively, within 24 h after Htx. All available recipient and donor variables were analyzed to assess the risk of EGF occurrence. Overall, moderate-to-severe EGF occurred in 46 (11.1%) patients. Twenty-nine (63.04%) patients required peripheral or central ECMO support in the treatment of severe EGF and 17 (36.9%) patients required IABP support for the treatment of moderate EGF. The predictive risk factors for moderate-to-severe EGF in recipients, as assessed by logistic regression analysis, were a preoperative transpulmonary gradient > 12 mm Hg (odds ratio [OR] 5.2; P = 0.023), a preoperative inotropic score > 10 (OR 8.5; P = 0.0001), and preoperative ECMO support (OR 4.2; P = 0.012). For donors, the predictive risk factor was a donor score ≥ 17 (OR 8.3; P = 0.006). The absence of EGF was correlated with improved long-term survival: 94% at 1 year and 81% at 5 years without EGF versus 76% and 36% at 1 year (P < 0.001), and 70% and 28% at 5 years (P < 0.001) with EGF requiring IABP and ECMO support, respectively. In-hospital weaned and survived patients after IABP or ECMO treatment for moderate-to-severe EGF had a similar 5-year conditional survival rate as transplant patients who had not suffered EGF: 88% without EGF versus 84% with EGF treated with mechanical circulatory support devices (P = 0.08). The occurrence of EGF is a multifactorial deleterious event that depends on donor and recipient profiles. IABP and ECMO support are reliable treatment strategies, depending on the grade of EGF. Furthermore, surviving patients treated with IABP or ECMO have the same long-term conditional survival rate as patients who have not suffered EGF.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Role of Intra‐Aortic Balloon Pump and Extracorporeal Membrane Oxygenation in Early Graft Failure After Cardiac Transplantation

Loforte¹,

Murana²,

Cefarelli³

et al. 2016

Artificial Organs

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“…A systematic literature review and meta-analysis of observational studies conducted by Borisenko et al [25] included 53 publications with data of a total of 999 patients. The authors reported the survival rate while on support as 62-83%, and 30-day survival as 41-66%, depending on the placement indication.…”

Section: Discussionmentioning

confidence: 99%

The Levitronix CentriMag ventricular assist device as a bridge to decision in patients with end-stage heart failure: Our single-center experience

Rabuş¹

2017

Turk Gogus Kalp Dama

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Rabuş MB, Salihi S, Hasanov S, Fedakar A, Çevirme D, Balkanay M. The Levitronix CentriMag ventricular assist device as a bridge to decision in patients with end-stage heart failure: Our single-center experience. Turk Gogus Kalp Dama 2017;25(4):543-9. ABSTRACTBackground: In this study, we report early outcomes of Levitronix CentriMag device implantation for bridge to decision for patients with end-stage heart failure in a single center.

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“…Additionally, the various centrifugal pump designs can have significant effects on hemodynamic performance . PediMag and CentriMag pumps have been successfully used in pediatric and adult patients requiring Ventricular Assist Device (VAD) and ECMO support . They have similar magnetically levitated, bearingless impellers and utilize the same hardware platform (motor and console) .…”

Section: Introductionmentioning

confidence: 99%

Evaluation of centrifugal blood pumps in term of hemodynamic performance using simulated neonatal and pediatric ECMO circuits

et al. 2019

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The objective of this translational study was to evaluate the FDA‐approved PediMag, CentriMag, and RotaFlow centrifugal blood pumps in terms of hemodynamic performance using simulated neonatal and pediatric extracorporeal membrane oxygenation (ECMO) circuits with different sizes of arterial and venous cannulae. Cost of disposable pump heads was another important variable for this particular study. The experimental circuit was composed of one of the centrifugal pump heads, a polymethylpentene membrane oxygenator, neonatal and pediatric arterial/venous cannulae, and 1/4‐inch ID tubing. Circuits were primed with lactated Ringer’s solution and packed human red blood cells (hematocrit 35%). Trials were conducted at 36°C using the three pump heads and different cannulae (arterial/venous cannulae: 8 Fr/18 Fr, 10 Fr/20 Fr, and 12 Fr/22 Fr) at various flow rates (200–2400 mL/min, 200 mL/min increments) and rotational speeds. Pseudo patient pressure was 60 mm Hg. Real‐time pressure and flow data were recorded for analysis. The RotaFlow pump had a higher pressure head and flow range compared with the PediMag and CentriMag pumps at the same rotational speed and identical experimental settings (P < 0.001). The PediMag pump had lower flow output than others (P < 0.001). Small‐caliber arterial cannulae and higher flow rates predictably created higher circuit pressures and pressure drops. There was no significant difference in hemodynamic energy delivered to the pseudo patient with each of the three pumps. The arterial cannula had the highest pressure drop and hemodynamic energy loss in the circuit when compared to the oxygenator and arterial tubing. The RotaFlow centrifugal pump had a significantly better hemodynamic performance when compared to the PediMag and CentriMag blood pumps at identical experimental conditions in simulated neonatal and pediatric ECMO settings. In addition, the cost of the RotaFlow pump head ($400) is 20 to 30‐fold less than the other centrifugal pumps [CentriMag ($12 000) or PediMag ($8000)] that were evaluated in this translational study.

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Thoratec CentriMag for Temporary Treatment of Refractory Cardiogenic Shock or Severe Cardiopulmonary Insufficiency

Abstract: Supplemental Digital Content is available in the text.

Cited by 83 publications

References 48 publications

Role of Intra‐Aortic Balloon Pump and Extracorporeal Membrane Oxygenation in Early Graft Failure After Cardiac Transplantation

Role of Intra‐Aortic Balloon Pump and Extracorporeal Membrane Oxygenation in Early Graft Failure After Cardiac Transplantation

The Levitronix CentriMag ventricular assist device as a bridge to decision in patients with end-stage heart failure: Our single-center experience

Evaluation of centrifugal blood pumps in term of hemodynamic performance using simulated neonatal and pediatric ECMO circuits

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