Challenging treatment of an infected circulite synergy micropump after pump thrombosis due to subtherapeutic anticoagulation therapy: Pushing the limits?

摘要

As a response to the shortage of donor organs for heart transplantation (HTX), left ventricular assist device (LVAD) therapy has proven to be safe and efficient as a bridge to transplant for patients awaiting donor organs (1,2). Vast progress has been achieved in this field over the last few years, and new generations of small-size assist devices have become the standard of care for end-stage heart failure (HF). The new CircuLite Synergy micropump (CircuLite, Saddle Brook, NJ, USA), which provides partial hemodynamic support, can be easily implanted via a small right-sided minithoracotomy and a small incision near the right clavicular groove without cardio-pulmonary bypass (CPB). It provides a partial flow up to 4.25 L/min and was primarily designed for "less sick" patients with severe heart failure. Early implantation of the Synergy device in such patients has been shown to be feasible and associated with significantly improved hemodynamics and quality of life (3,4).