29-10-2014

Dr. Kyriakos Anastasiadis describes the use of the iVAC 3L as a mechanical left ventricular assist device in a patient suffering from end-stage heart failure (HF) complicated by pulmonary hypertension.

A 61-year-old male patient presented with chronic end-staged HF due to idiopathic dilated cardiomyopathy who suffered acute decompensation with pulmonary edema as a salvage procedure. The patient was in critical cardiogenic shock (INTERMACS level 1) with an ejection fraction of 20% and a cardiac index of 1.8L/min/m2 despite maximum inotropic support and IABP support.

The pump was inserted from the right axillary artery through an 8 mm vascular graft prosthesis and was positioned in the LV with the help of TEE.

After an initial period of hemolysis, which resolved in two days, the device functioned well on minimal anticoagulation (targeted ACT was 160-180 sec). The patient hemodynamics were immediately improved, pulmonary edema resolved, and the patient was weaned from the IABP and inotropic support. Eventually, the clinical and hemodynamic status of the patient returned to the pre-shock condition (cardiac output increased, pulmonary capillary wedge pressure dropped), LV ejection fraction showed improvement with decreasing LV end-diastolic dimension

measured by echocardiography and BNP levels significantly decreased (INTERMACS level 3). This allowed us to wean the patient from the device on the 10th post-implantation day.

Testimonial

I was very pleased with the performance of the iVAC 3L™, and considered it a valuable option for cases of acute and chronic heart failure when IABP support is inadequate and an LVAD is not readily available.

– Dr. Kyriakos Anastasiadis, FETCS, Assistant Professor of Cardiothoracic Surgery, Aristotle University of Thessaloniki, Cardiothoracic Department, AHEPA Hospital, Thessaloniki, Greece.