The Thoratec Implantable Ventricular Assist Device (IVAD): initial clinical experience.
BACKGROUND
The Thoratec Implantable Ventricular Assist Device (IVAD) is the only FDA-approved intracorporeal biventricular cardiac assist device. It is a titanium-coated version of its predecessor, the Paracorporeal Ventricular Assist Device (PVAD). The blood pump is compatible with the portable TLC-II driver, making home discharge feasible.


METHODS
Nine consecutive patients were implanted with the IVAD from June 2005 through March 2006. The indications for support were acute heart failure in 6 cases and chronic heart failure in 3 cases. All patients were managed with maximal medical therapies including intravenous inotropic drugs prior to implant.


RESULTS
All patients survived the surgical implant. Six patients were considered successful: 3 patients discharged to home and subsequently received transplantation, 2 are awaiting transplantation (1 at home and 1 in-house), and 1 patient was successfully explanted. Three patients expired postoperatively because of multiple organ system failure (2 patients) and pulmonary hemorrhage (1 patient). There were no device malfunctions. There was 1 localized driveline site infection and 1 thromboembolic event with partial visual loss.


CONCLUSIONS
The IVAD is a unique device capable of providing uni- or bi-ventricular support for either acute or chronic heart failure conditions. Its versatility permits bridge to transplant or recovery options. Home discharge is feasible.
Samuels
Louis E
LE
Department of Cardiothoracic Surgery, The Lankenau Hospital, Wynnewood, PA 19096, USA. SamuelsLE@aol.com
Holmes
Elena C
EC
Hagan
Kevin
K
Gopalan
Radha
R
Droogan
Christopher
C
Ferdinand
Francis
F
D000328:Adult; D000368:Aged; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D006333:Heart Failure / Q000175:diagnosis* / Q000601:surgery*; D006353:Heart-Assist Devices; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D019919:Prosthesis Implantation / Q000379:methods*; D016896:Treatment Outcome