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Insertion, Maintenance, and Removal of the Percutaneous Dual Lumen Cannula Right Ventricular Assist Device
Published on: July 20, 2022
Extended and Safe Support with the CentriMag® Temporary Ventricular Assist Device Implanted with Skirted-Cannula
Chan-Yang Hsu1, I-Shiang Tzeng2, Jenn-Yeu Song1
1Division of Cardiovascular Surgery, Department of Surgery.
Insights
Extended use of the CentriMag ventricular assist device (VAD) beyond 30 days, particularly with the skirted cannula technique, demonstrates acceptable survival rates for patients awaiting recovery or transplantation.
Area of Science:
- Cardiology
- Medical Devices
- Surgical Technology
Background:
- CentriMag® is indicated for temporary circulatory support up to 30 days.
- Extended use beyond this period is common, with variable outcomes.
- Experience with prolonged CentriMag support needs further review.
Purpose of the Study:
- To review the clinical experience with extended CentriMag support.
- To evaluate outcomes of patients requiring circulatory support for over 30 days.
- To assess the safety and efficacy of the skirted cannula technique for CentriMag LVAD implantation.
Main Methods:
- Retrospective analysis of 19 patients supported with CentriMag LVAD.
- Patients received support as a bridge to recovery, VAD, or transplantation.
- Data collected from September 2011 to October 2021.
Main Results:
- 14 out of 19 patients received support for longer than 30 days.
- The overall 1-year survival rate was 73.7%.
- Support duration ranged from 6 to 191 days (median 41 days).
Conclusions:
- The skirted cannula technique for CentriMag LVAD implantation is safe and durable.
- Extended use of CentriMag (over 30 days) is associated with acceptable survival.
- Complications were not common with this technique and duration of support.
Objectives:
CentriMag® (Abbott, Pleasanton, CA, USA) is indicated for temporary circulatory support for up to 30 days. Extended support is not uncommon, and the results vary considerably. Herein, we review our experience on extended support.
Methods:
We retrospectively analyzed 19 patients supported with CentriMag as a bridge to recovery, long-term ventricular assist device or transplantation from September 2011 to October 2021.
Results:
Nineteen patients (16 men and 3 women; mean age 51.7 ± 9.2 years) had CentriMag left ventricular assist device (LVAD) implantation with the skirted-cannula technique. Twelve (63.2%), 6 (31.6%), and 1 (5.3%) patient were in INTERMACS 1, 2, and 3, respectively. The aims of support were bridge-to-decision in 3 patients (15.8%), and bridge-to-transplantation in 16 patients (84.2%). Fourteen patients were supported for longer than 30 days, while 5 patients had their CentriMag removed before 30 days. Of the 5 patients supported for less than 30 days, 3 died early after implantation due to complications of prolonged shock. The other 2 patients were successfully transplanted. Among the 14 patients supported for longer than 30 days, 1 patient died after transplantation and 13 patients survived either after transplantation or weaning off CentriMag. The overall 1-year survival rate was 73.7%. The duration of support for all patients ranged from 6 to 191 days (64 ± 61 days; median 41 days).
Conclusions:
The skirted cannula technique for apical cannulation in implantation of CentriMag LVAD is an easy, safe and durable technique. Immediate post-operative and long-term complications are not common. Its use over 30 days is associated with acceptable survival.
