%0 Journal Article
%T Temporary mechanical circulatory support for refractory heart failure: the German Heart Center Berlin experience
%A Nersesian, Gaik
%A Hennig, Felix
%A Müller, Marcus
%A Mulzer, Johanna
%A Tsyganenko, Dmytro
%A Starck, Christoph
%A Gromann, Tom
%A Falk, Volkmar
%A Potapov, Evgenij
%A Schoenrath, Felix
%J Annals of Cardiothoracic Surgery
%D 2018
%B 2018
%9 
%! Temporary mechanical circulatory support for refractory heart failure: the German Heart Center Berlin experience
%K 
%X  Background:  Temporary mechanical circulatory support (MCS) offers a valuable option for treatment of refractory heart failure. We present our experience with selected MCS devices in cardiogenic shock of different etiologies.   Methods:  We retrospectively studied patients who were treated in our institution between 01/2016 and 07/2018. Patients receiving only veno-arterial extracorporeal membrane oxygenation (VA-ECMO) support were excluded. Left ventricular support patients received Impella; right ventricular support was conducted using Levitronix CentriMag.   Results:  Thirty-seven patients received an Impella left ventricular assist device (LVAD). Etiology was: acute on chronic ischemic cardiomyopathy (ICMP; n=12), acute myocardial infarction (AMI; n=11), dilated cardiomyopathy (DCMP; n=7) and toxic cardiomyopathy (TCMP; n=2). Two patients presented with postcardiotomy shock and acute myocarditis, respectively. In one case, Takotsubo cardiomyopathy was diagnosed. Impella was used solely in 28 patients (Impella group) with an in-hospital survival of 37%. In nine patients, Impella was used in combination with extracorporeal life support (ECLS) implantation (ECMELLA group)—in-hospital survival was 33%. In the Impella group six patients recovered, six received a long-term VAD and 16 died on device. In the ECMELLA group one patient recovered, three received a long-term VAD and five died. The majority of CentriMag implantations as a right ventricular assist device (RVAD) were necessary after LVAD implantation (n=52); of these patients, 14 recovered, eight received long-term VAD and 30 died. The remaining 17 patients were supported by RVAD due to AMI (n=7); postcardiotomy (n=7); right heart failure after heart transplantation (n=2) and ICMP (n=1). Six of these patients recovered, two required long-term VAD and nine died.   Conclusions:  Survival after MCS implantation for left as well as right heart failure in cardiogenic shock remains low, but is superior to that of patients without mechanical support. Short-term MCS remains an option of choice if right, left or biventricular support is needed.
%U https://www.annalscts.com/article/view/16563
%V 8
%N 1
%P 76-83
%@ 2304-1021