title: Circulatory support for long-term treatment of heart failure: experience with an intraventricular continuous flow pump.
abstract: 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.
authors.affiliation: Oxford Heart Centre, Oxford, UK. swestaby@AHF.org.uk
authors.forename: Stephen
authors.initials: S
authors.lastname: Westaby
authors.forename: Adrian P
authors.initials: AP
authors.lastname: Banning
authors.forename: Satoshi
authors.initials: S
authors.lastname: Saito
authors.forename: David W
authors.initials: DW
authors.lastname: Pigott
authors.forename: Xu Y
authors.initials: XY
authors.lastname: Jin
authors.forename: Pedro A
authors.initials: PA
authors.lastname: Catarino
authors.forename: Desiree
authors.initials: D
authors.lastname: Robson
authors.forename: Narain
authors.initials: N
authors.lastname: Moorjani
authors.forename: Attila
authors.initials: A
authors.lastname: Kardos
authors.forename: Philip A
authors.initials: PA
authors.lastname: Poole-Wilson
authors.forename: Robert
authors.initials: R
authors.lastname: Jarvik
authors.forename: O H
authors.initials: OH
authors.lastname: Frazier
mesh_terms: 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*
chemical_list: D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors