Document Detail


Transapical miniaturized ventricular assist device: design and initial testing.
MedLine Citation:
PMID:  21320708     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Left ventricular assist devices are increasingly used to treat patients with advanced and otherwise refractory heart failure as bridge to transplant or destination therapy. We evaluated a new miniaturized left ventricular assist device that requires minimal surgery for implantation, potentially allowing implantation in earlier stage heart failure.
METHODS: HeartWare (Miami Lakes, Fla) developed transapical miniaturized ventricular assist device. Acute (n = 4), 1-week (n = 2), and 30-day (n = 4) bovine model experiments evaluated hemodynamic efficacy and biocompatibility of the device, which was implanted through small left thoracotomy with single insertion at apex of left ventricle without cardiopulmonary bypass. The device outflow cannula was positioned across the aortic valve. The international normalized ratio was maintained between 2.0 and 2.5 with warfarin. Hemodynamic, echocardiographic, fluoroscopic, hematologic, and blood chemistry measurements were evaluated.
RESULTS: The device was successfully implanted through the left ventricular apex in all 10 animals. The device was operated at 15,000 ± 1000 rpm (power consumption, 3.5-6.0 W). The device maintained normal end-organ perfusion with no significant hemolysis (0-30 mg/dL). There were no pump failures or device-related complications. At autopsy, no abnormalities were seen in endocardium, aortic valve leaflets, or aortic root. There was no evidence of thromboembolism or abnormalities in any peripheral end organs.
CONCLUSIONS: We successfully demonstrated feasibility of a novel intraventricular assist device that can be completely implanted through left ventricular apex. This transapical surgical approach eliminates needs for sternotomy, device pocket, cardiopulmonary bypass, ventricular coring, and construction of an outflow graft anastomosis.
Authors:
Mark S Slaughter; Guruprasad A Giridharan; Dan Tamez; Jeff LaRose; Mike A Sobieski; Leslie Sherwood; Steven C Koenig
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2011-02-12
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  142     ISSN:  1097-685X     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-08-16     Completed Date:  2011-10-13     Revised Date:  2013-12-13    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  668-74     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2011 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Animals
Cattle
Equipment Design
Heart Ventricles
Heart-Assist Devices*
Male
Miniaturization
Models, Animal
Prosthesis Implantation / methods*
Grant Support
ID/Acronym/Agency:
1 R43 HL103014-01A1/HL/NHLBI NIH HHS; R43 HL103014/HL/NHLBI NIH HHS
Comments/Corrections

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