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

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.