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Short-term ventricular assist device in post-cardiotomy cardiogenic shock: factors influencing survival

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  • Artificial Heart (Clinical)
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Abstract

Post-cardiotomy cardiogenic shock (PCCS) results in substantial morbidity and mortality, whereas refractory cases require mechanical circulatory support. The aim of this study was to evaluate factors influencing survival during short-term ventricular assist support in PCCS. In total, 154 CentriMag® (Thoratec; CA, USA) devices were implanted for cardiogenic shock between 2004 and 2011 out of which 31 were for PCCS. A retrospective review was performed in 31 PCCS patients who required the CentriMag short-term VAD as a bridge to decision. Survivors and non-survivors were compared with respect to pre- and intra-operative characteristics as well as duration of short-term VAD support. Mean duration of support was 11.7 ± 15.4 days (range 1–65 days). Seventeen (54.83 %) patients died on support, 14 (45.16 %) were weaned off or upgraded to long-term device, while 11 (35.5 %) were discharged home. The overall survival to myocardial recovery and device explantation, or upgrade to a long-term VAD, was 41.9 % (n = 13) at the study cutoff. EuroSCORE II was significantly higher in non-survivors as compared to survivors (p = 0.047). The duration of short-term VAD support was significantly longer in survivors (p < 0.001). The CentriMag is a versatile, safe and effective short-term circulatory support for patients with PCCS as a bridge to decision which enables longer support and better recovery of both heart and end-organ function and thus may improve the survival of PCCS patients. Lower EuroSCORE may be essential for myocardial recovery in PCCS.

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Cardiothoracic Transplantation and Mechanical Circulatory Support, Royal Brompton & Harefield NHS Foundation Trust, Harefield Hospital, Hill End Road, Harefield, Middlesex, London, UB9 6JH, UK

    Prashant N. Mohite, Anton Sabashnikov, Nikhil P. Patil, Diana García Sáez, Bartlomiej Zych, Aron F. Popov, Alexander Weymann, Nandor Marczin, Fabio DeRobertis, Toufan Bahrami, Mohamed Amrani & André R. Simon

  2. Department of Cardiothoracic Surgery, Heart Center, University Hospital of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany

    Anton Sabashnikov & Thorsten Wahlers

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  1. Prashant N. Mohite
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  2. Anton Sabashnikov
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  3. Nikhil P. Patil
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  4. Diana García Sáez
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  5. Bartlomiej Zych
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  6. Aron F. Popov
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  7. Alexander Weymann
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  9. Nandor Marczin
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  10. Fabio DeRobertis
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  11. Toufan Bahrami
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  12. Mohamed Amrani
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  13. André R. Simon
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Correspondence to Anton Sabashnikov.

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Prashant N. Mohite and Anton Sabashnikov have contributed equally to this article.

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Mohite, P.N., Sabashnikov, A., Patil, N.P. et al. Short-term ventricular assist device in post-cardiotomy cardiogenic shock: factors influencing survival. J Artif Organs 17, 228–235 (2014). https://doi.org/10.1007/s10047-014-0773-1

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  • DOI: https://doi.org/10.1007/s10047-014-0773-1

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