Miniature axial flow pump for ventricular assistance in children and small adults.
We investigated the efficacy of the Jarvik 2000 intraventricular assist device (Jarvik Research, Inc., New York, N.Y.) in an ovine model. The device is an axial flow pump measuring 1.8 cm in diameter by 5 cm long, has a displacement volume of 12 ml, and can deliver flow from 2 to 7 L/min. Seven devices were implanted through a left thoracotomy into the left ventricle with an outflow graft to the descending aorta. Animals were treated with warfarin sodium and aspirin to maintain prothrombin times approximately 1.5 times control. Animals were followed up for 3 to 123 days. Two animals died of operative complications at days 3 and 5. One device failed at 58 days because of thrombus formation at the inflow side of the impeller. The remaining four animals were killed at days 19, 42, 42, and 123, respectively, because of broken electric power cables. Hematocrit values rose significantly higher than preoperative levels (22.8% +/- 3.8% to 30.5% +/- 3.4%); premortem elevations of values higher than baseline values of plasma free hemoglobin (10.4 +/- 7.8 mg/dl to 17.1 +/- 7.4 mg/dl) and lactate dehydrogenase (391.5 +/- 113.7 units/L to 771.2 +/- 370.8 units/L) were statistically insignificant. Serum creatinine and bilirubin levels were normal. No end-organ dysfunction arising from long-term support was evident clinically or at postmortem examination, nor was there any evidence of embolism or damage to intracardiac structures. We found the Jarvik 2000 intraventricular assist device to be easily implantable, safe, nonhemolytic, and able to provide physiologic flow with power requirements under 10 watts.
Kaplon
R J
RJ
Cardiopulmonary Transplantation Research Laboratory, Columbia-Presbyterian Medical Center, New York, NY 10032, USA.
Oz
M C
MC
Kwiatkowski
P A
PA
Levin
H R
HR
Shah
A S
AS
Jarvik
R K
RK
Rose
E A
EA
D000328:Adult; D000818:Animals; D000925:Anticoagulants / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D001807:Blood Vessel Prosthesis; D002648:Child; D003326:Coronary Circulation / Q000502:physiology; D011211:Electric Power Supplies; D004617:Embolism / Q000517:prevention & control; D004867:Equipment Design; D006353:Heart-Assist Devices; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D011093:Polyethylene Terephthalates; D012756:Sheep; D013927:Thrombosis / Q000517:prevention & control; D014859:Warfarin / Q000627:therapeutic use
D000925:Anticoagulants; D011093:Polyethylene Terephthalates; D014859:Warfarin; D006493:Heparin; D001241:Aspirin