Puente al trasplante de 4 semanas utilizando el sistema de asistencia ventricular LEVITRONIX CENTRIMAG® en el shock cardiogénico post-infarto al miocardio. Caso clínico.

Resumen

Introduction. Myocardial infarction cardiogenic shock portends a high mortality even if early revascularization is achieved. Biventricular assist devices have not been used in Chile in this critical setting.

Methods/Results. We report a case of a 55 year-old diabetic man who suffered an acute chest pain and ventricular fibrillation. Prompt out-side hospital cardioversion/reanimation restored pulse and allowed emergency room transfer on mechanical ventilation. Electrocardiogram showed an anterior myocardial infarction and early revascularization was achieved by anterior descending artery angioplasty. However, severe cardiogenic shock continued in spite of inotropic and intraortic balloon pump support. LEVITRONIX CENTRIMAG® biventricular mechanical circulatory support was inserted during reanimation for recurrent ventricular fibrillation and the patient listed for urgent cardiac transplantation upon stabilization. Heart transplantation was performed successfully 28 days later and the patient dismissed after a 21-day recovery period. Six months after transplant patient is in NYHA functional class I with normal biventricular function.

Conclusion. LEVITRONIX CENTRIMAG® biventricular mechanical circulatory support could be used successfully as a bridge-to-transplant for myocardial infarction cardiogenic shock. This is the longest biventricular circulatory support reported in Chile.