Levitronix Centrimag as a bridge to solution in patients with advanced heart failure – a single centre experience

Objective: Ventricular assist devices (VADs) offer very valuable therapeutic options for patients with end-stage heart failure, either as a short-term support, as bridge to transplant, bridge to recovery or as destination therapy. The Levitronix® (Levitronix LLC, Waltham, Mass) system is extra corporeal short term mechanical circulatory assist device designed for treatment of patients with acute cardiogenic shock of any aetiology.

Methods: A retrospective review was performed from June 2003 and October 2011 of 125 patients with advanced heart failure who were initially supported with Levitronix CentriMag system as a bridge to recovery, long term VAD or transplantation. Levitronix Centrimag is a single-use extracorporeal centrifugal blood pump based on bearing-less motor technology. The main component is the rotor in the pump head which is levitated magnetically, so that frictionless rotation may be achieved without regions of stasis or wear and tear.

Results: 125 consecutive adult patients were supported with 140 Levitronix devices (3793 days) at our institution with indications to wean from the cardiopulmonary bypass in the setting of postcardiotomy (PC = 28), primary graft failure (PGF = 33), and refractory heart failure not controlled by medical therapy (RHF = 79). Left ventricle was supported in 35 (LVAD), right ventricle was supported in 40 (RVAD), while both the ventricles were supported in 65 cases (BiVAD). The mean support time was 14.35 ± 18.93 days (range: 1 – 66 days) in PC, 16.12 ± 13.95 days (range: 1 – 45 days) in PGF and 36.48 ± 32.29 (range: 1 – 167 days) in RHF. In the PC cohort, 10 (35.71%) patients were weaned from support while 16 (48.48%) and 53 (67.08%) patients were weaned from support in PGF and RHF group respectively. 17 patients (Levitronix BIVAD = 11, LVAD = 6) were bridged to long term VAD and 6 (Levitronix BIVAD = 5, LVAD = 1) were bridged to transplantation directly without long term VAD. 30 Levitronix devices were put to support right ventricular failure after long term LVAD implantation out of which 23 (76.67%) could be weaned off from RVAD while 7 (23.33%) died on support. 18 (64.29%), 17 (51.52%) and 26 (32.92%) patients died on support in PC, PGF and RHF groups respectively. There were no device failures observed.

Conclusion: The Levitronix CentriMag has proven to be a versatile, safe and effective short-term circulatory support for patients with end-stage heart failure as a bridge to decision or to heart transplantation.