Circulatory support for long-term treatment of heart failure: experience with an intraventricular continuous flow pump.
BACKGROUND
A lifetime mechanical solution for advanced heart failure must be reliable, with a low risk of life-threatening complications. After extensive laboratory testing, we began clinical trials with an axial flow pump for long-term treatment of New York Heart Association class IV, transplant-ineligible patients.


RESULTS
The Jarvik 2000 is a continuous flow device that is implanted in the apex of the left ventricle with offloading to the descending thoracic aorta. Skull-based percutaneous power delivery was derived from cochlear implant technology. We used this system in 4 patients with end-stage dilated cardiomyopathy. Exercise capacity, quality of life, device parameters, and native heart function were monitored serially. One patient died from right heart failure at 3 months. The other patients were discharged from hospital between 3 and 8 weeks postoperatively and are currently New York Heart Association I or II. Follow-up lasted between 9 and 20 months. There has been no device failure or hemolysis. Native heart function and quality of life were markedly improved.


CONCLUSIONS
The Jarvik 2000 is a true assist (rather than replacement) device that functions synergistically with the native left ventricle and provides excellent quality of life. Adverse events are infrequent. This blood pump may provide a mechanical solution for end-stage heart failure in the community.
Westaby
Stephen
S
Oxford Heart Centre, Oxford, UK. swestaby@AHF.org.uk
Banning
Adrian P
AP
Saito
Satoshi
S
Pigott
David W
DW
Jin
Xu Y
XY
Catarino
Pedro A
PA
Robson
Desiree
D
Moorjani
Narain
N
Kardos
Attila
A
Poole-Wilson
Philip A
PA
Jarvik
Robert
R
Frazier
O H
OH
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D001835:Body Weight; D006348:Cardiac Surgical Procedures / Q000009:adverse effects; D002311:Cardiomyopathy, Dilated / Q000150:complications / Q000628:therapy*; D004452:Echocardiography; D004867:Equipment Design; D017079:Exercise Tolerance; D005500:Follow-Up Studies; D006333:Heart Failure / Q000150:complications / Q000628:therapy*; D006334:Heart Function Tests; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D006353:Heart-Assist Devices / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011788:Quality of Life; D020127:Recovery of Function; D015996:Survival Rate; D013927:Thrombosis / Q000517:prevention & control; D013995:Time; D016896:Treatment Outcome; D018754:Ventricular Dysfunction / Q000150:complications / Q000628:therapy*
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors