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Updated: Nov 6, 2025
Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
Published on: June 12, 2021
Use of CentriMag for refractory cardiogenic shock in a puerperal woman: case report
Paulo Manuel Pêgo-Fernandes1, Augusto Scalabrini Neto2, Ludhmila Abrahão Hajjar3
1MD, PhD. Full Professor, Thoracic Surgery Division, Instituto do Coracao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR; and Cardiothoracic Surgeon, Hospital Sírio Libanês (HSL), São Paulo (SP), Brazil.
Insights
Mechanical circulatory assist devices (MCADs) offer a life-saving option for severe heart failure. A case report highlights successful recovery using a CentriMag device in a young woman with refractory cardiogenic shock.
Area of Science:
- Cardiology
- Mechanical Circulatory Support
Background:
- Heart failure poses a significant public health challenge in Brazil, characterized by high morbidity and mortality.
- Mechanical circulatory assist devices (MCADs) have emerged as increasingly vital treatment options over the past decade.
Observation:
- A case report details a 35-year-old puerperal female experiencing refractory cardiogenic shock secondary to acute myocarditis.
- Initial treatments including dobutamine, intra-aortic balloon pump (IABP), and venoarterial extracorporeal membrane oxygenation (VA-ECMO) failed to improve perfusion.
- A CentriMag MCAD was implanted due to persistent biventricular dysfunction.
Findings:
- The patient demonstrated recovery from biventricular dysfunction following the implantation of the CentriMag device.
- The device was successfully explanted after 10 days, and the patient was discharged 8 days later.
- Coxsackie virus was identified as the cause of the myocarditis.
Implications:
- Individualized patient assessment is crucial for MCAD implantation, as clinical profiles may not align with standard guidelines.
- Multidisciplinary team discussion was essential for the successful management and reversal of the patient's critical condition.
- This case underscores the potential of MCADs, such as the CentriMag, in managing severe, refractory cardiogenic shock.
Context:
Heart failure in Brazil is a major public health problem and, even with advances in treatment, it still presents high morbidity and mortality. As a treatment option, mechanical circulatory assist devices (MCADs) have greatly increased in importance over the last decade.
Case Report:
This report concerns a case of refractory cardiogenic shock due to acute myocarditis in a 35-year-old puerperal female patient who presented with retrosternal pain, fatigue and dyspnea. At the hospital, she was diagnosed with myocarditis. There was no improvement in perfusion even after receiving dobutamine, intra-aortic balloon passage (IAB) and venoarterial extracorporeal membrane oxygenation (VA-ECMO). Therefore, it was decided to implant a MCAD (CentriMag). During hospitalization, recovery from the bi-ventricular dysfunction was achieved. The CentriMag device was removed 10 days after it had been implanted, and the patient was discharged after another 8 days. The myocarditis was proven to be due to the Coxsackie virus.
Conclusions:
The decision to implant a MCAD should be individualized, as patient profiles do not always match the indications in the guidelines and protocols. In this study, clinical discussion of the case among the medical and multi-professional teams was essential in order to be able to successfully reverse the patient's severe clinical condition without sequelae, through using a CentriMag implant.
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