Survival on biventricular mechanical support with the Centrimag as a bridge to decision: A single-center risk stratification

Objective: Temporary mechanical assist devices are increasingly being used as a lifesaving bridge to decision in patients requiring cardiopulmonary resuscitation. We report our single-center experience with biventricular Centrimag pumps over a five-year period. Method: Data was retrospectively collected in consecutive patients who required biventricular support from 2008 to 2013. Patients who were supported with central cannulation using the Centrimag system were analyzed. In addition to demographic information, data pertaining to indications, outcomes and mortality were collected. Results: The cohort consisted of 48 patients (19 women and 29 men, mean age of 56 years). The median duration of support was 14 days. The median duration to patient expiration while still on the Centrimag was 12 days. Thirty-day survival was 56% (27/48). Nine patients were explanted to recovery, while fourteen patients were converted to a durable LVAD, two of whom were then transplanted. We stratified patients into two groups. Group I comprised patients who were either explanted to recovery, converted to durable LVAD or transplanted (23/48) and Group II consisted of patients who either died on the Centrimag or were explanted for withdrawal of care (25/48). Statistical analysis did not reveal any clinically significant differences between the two groups in terms of age, sex, etiology, hemodynamic, co-morbidities or laboratory parameters. Conclusion: The biventricular Centrimag can be used as a bridge to decision in patients with thirty-day survival of <50%. Parameters to predict 30-day survival in this high-risk cohort continue to remain elusive.