Ventricular assistance with microaxial flow pump following mitral repair for dilated cardiomyopathy.

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 end-stage 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.