Ventricular Assistance with Microaxial Flow Pump following Mitral Repair for Dilated Cardiomyopathy

Abstract

Background Postcardiotomy heart failure is still the main cause of death in patients undergoing palliative surgery for end-stage dilative cardiomyopathy. New micro-axial flow ventricular assisting devices (LVAD) have been suggested in such cases. Objective Evaluate the effect of the new LVAD on short-term outcome of a patient admitted for endstage heart failure. Study Design Case report. Data Sources One patient admitted for severe mitral regurgitation secondary to end-stage dilative cardiomyopathy and chronic atrial fibrillation (AF). Intervention Preoperative intraaortic balloon pump (IABP) insertion, mitral plasty with radiofrequency ablation of AF, microaxial flow LVAD support. Results The patient was unweanable from cardiopulmonary bypass until microaxial flow LVAD unloaded the left ventricle and restored adequate cardiac function. The patient was discharged home and is still well at 5 months folllow-up Conclusions The miniinvasive insertion and withdrawal, low anticoagulation protocols, and the possibility of coupling with IABP make the microaxial flow LVAD promising for patients with end-stage heart failure undergoing surgery.

Endocardial Injury During Ventricular Assistance with an Intracardiac Microaxial Pump

“…However cases of functional mitral stenosis secondary to pump placement have been reported [8]. Minimal blood damage during pumping and a light anticoagulation level required provide a low rate of hemorrhagic complications [1][2][3][4]. Fig.…”

“…It has been successfully used in postcardiotomy low out-put syndrome refractory to intra-aortic balloon pump and inotropic drugs [1][2][3]. It consists of a straight flexible cannula which is surgically inserted through the ascending aorta across the aortic valve into the left ventricle.…”