A 60-year-old male patient presented to an outside hospital with severe
cardiogenic shock. A triple bridge of mechanical circulatory support was
utilized to transition him to heart transplantation listing. Initially, coronary
artery disease was percutaneously treated and Impella 2.5 was used as mechanical
circulatory support for 5 days followed by the second Impella 2.5 for 4 days.
Veno-arterial extracorporeal membrane oxygenation support was deployed for
16 days. This was exchanged for HeartWare ventricular assist device support as
the third stage of mechanical circulatory support to heart transplantation
listing. The patient experienced acute renal failure which was managed by
continuous renal replacement therapy then intermittent hemodialysis with
eventual complete recovery of the renal function. He was discharged home 56 days
after HeartWare ventricular assist device implantation with stable hemodynamic,
intact neurologic status and fully recovered renal function. Currently, the
patient is listed for heart transplantation.