Journal of Cardiology and Heart Failure

ABSTRACT

Background

Cardiopulmonary resuscitation (CPR) in patients supported by left ventricular assist devices (LVADs) presents unique challenges. While manual chest compressions are recommended in the setting of hypoperfusion, the safety and efficacy of mechanical CPR devices in this population remain poorly defined.

Case Summary

We report the case of an elderly female with non-ischemic cardiomyopathy supported by a durable LVAD as destination therapy who suffered cardiac arrest at home. Prolonged mechanical CPR using a piston-driven device (LUCAS) was initiated by emergency medical services and continued for 45 minutes, resulting in restoration of Doppler-measured perfusion. Despite preserved LVAD function without device dislodgement, the patient sustained catastrophic thoracic injury, extensive embolic cerebral infarctions, multiorgan failure, and ultimately poor neurological recovery, leading to withdrawal of care.

Keywords: Cardiopulmonary Resuscitation; Cardiomyopathy; Left Ventricular Assist Devices; LUCAS Device; Doppler-measured Perfusion.