title: Biventricular support with the Jarvik 2000 ventricular assist device in a calf model of pulmonary hypertension.
abstract: The Jarvik 2000 ventricular assist device (VAD) is clinically efficacious for treating end-stage left ventricular failure. Because simultaneous right ventricular support is also occasionally necessary, we developed a biventricular Jarvik 2000 technique and tested it in a calf model. One VAD was implanted in the left ventricle with outflow-graft anastomosis to the descending aorta. The other VAD was implanted in the right ventricle with outflow-graft anastomosis to the pulmonary artery. Throughout the 30 day study, hemodynamic values were continuously monitored. On day 30, both pumps were evaluated at different speeds, under various hemodynamic conditions. By gradually occluding the pulmonary artery proximally or distally, we simulated varying degrees of high pulmonary vascular resistance, right ventricular hypertension, global heart failure, or ventricular fibrillation. The two VADs maintained biventricular support even during pulmonary artery occlusion and ventricular fibrillation, yielding a cardiac output of 3-11 L/min, left ventricular end-diastolic pressure of 11-24 mm Hg, and central venous pressure of 9-25 mm Hg. End-organ function was unimpaired, and no major adverse events occurred. The dual VADs offered safe, effective biventricular assistance in the calf. Additional studies are needed to assess the effects of lowered pulse pressure upon the pulmonary circulation and to develop a single pump speed controller.
authors.affiliation: Cardiovascular Research Laboratories, Texas Heart Institute at St. Luke's Episcopal Hospital, Houston, Texas 77225-0345, USA.
authors.forename: Michel
authors.initials: M
authors.lastname: Kindo
authors.forename: Branislav
authors.initials: B
authors.lastname: Radovancevic
authors.forename: Igor D
authors.initials: ID
authors.lastname: Gregoric
authors.forename: Jeff L
authors.initials: JL
authors.lastname: Conger
authors.forename: Kamuran
authors.initials: K
authors.lastname: Kadipasaoglu
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Tamez
authors.forename: Sheila R
authors.initials: SR
authors.lastname: Moore
authors.forename: Kenneth A
authors.initials: KA
authors.lastname: Golden
authors.forename: Katherine
authors.initials: K
authors.lastname: Robert
authors.forename: O H
authors.initials: OH
authors.lastname: Frazier
mesh_terms: D000818:Animals; D002302:Cardiac Output / Q000502:physiology; D002417:Cattle; D004195:Disease Models, Animal; D006352:Heart Ventricles / Q000601:surgery*; D006353:Heart-Assist Devices; D006976:Hypertension, Pulmonary / Q000628:therapy*; D019919:Prosthesis Implantation