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Long-Term Survival Under Biventricular Assist Device Support Despite Persistent Asystole.

Ibrahim Oguz Karaca1, Berhan Keskin1, Aykun Hakgor1

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This study details a 45-year-old man who lived for 43 months without heart activity using a biventricular assist device (BiVAD). The BiVAD successfully maintained circulation, showcasing long-term support in asystole.

Keywords:
biventricular assist devicecardiac standstillleft ventricular assist devicesurvivalventricular fibrillation

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Area of Science:

  • Cardiology
  • Medical Devices
  • Physiology

Background:

  • Mechanical circulatory support is crucial for end-stage heart failure.
  • Sustained cardiac asystole presents unique challenges for hemodynamic management.

Purpose of the Study:

  • To report a unique case of long-term survival with biventricular assist device (BiVAD) support in a patient with complete absence of cardiac electrical and mechanical activity.
  • To demonstrate the capability of BiVADs to maintain adequate systemic and pulmonary circulation in the absence of intrinsic cardiac function.

Main Methods:

  • Case report of a 45-year-old male patient.
  • Utilized biventricular assist device (BiVAD) for circulatory support.
  • Monitored hemodynamics, oxygenation, device flows, and cardiac activity via echocardiography.

Main Results:

  • The patient remained asymptomatic for 43 months despite persistent asystole.
  • Stable hemodynamics, oxygenation, and device flows were maintained throughout the support period.
  • Echocardiography confirmed the absence of native cardiac contractility and continuously open atrioventricular valves.

Conclusions:

  • Biventricular assist device (BiVAD) support can sustain adequate circulation in the absence of native cardiac activity.
  • This case represents the longest reported survival under sustained asystole with mechanical circulatory support.
  • BiVADs offer a viable option for long-term management in select patients with profound cardiac dysfunction.