title: Hemodynamic influence of tilting disc valve type on pump performance with the NIPRO-ventricular assist device.
abstract: The NIPRO-ventricular assist device (NIPRO-VAD) is an external pulsatile flow pump. Formerly, Sorin Carbocast, a monoleaflet tilting disc valve (SC valve), was used at the inlet/outlet parts of the pump, but Medtronic Hall (MH valve) is now used. We studied the differences in performance among pumps with different artificial valves. Six NIPRO pumps with SC valves and six with MH valves were examined using mock circuits. The systolic flow of the pump was measured with the ultrasonic flowmeter by changing the systolic fraction. Six patients wearing the NIPRO-VAD underwent periodic pump exchange from a pump with an SC valve to the one with an MH valve. The pump blood flow was measured at pre- and post-pump exchanges using an ultrasonic flowmeter. Blood pressure, serum LDH and AST levels were also compared before and after the pump exchange. Blood flow was significantly increased by using the NIPRO-VAD with the MH valve as compared to the SC valve in vitro. Under the same drive conditions pump flow tended to increase in six patients. No difference was found in patients' blood pressure, serum LDH or AST levels when using the SC or MH valve. From these results, the hemodynamic influence on patients due to replacement of the SC valve with the MH valve in the NIPRO-VAD is considered to be insignificant.
authors.affiliation: Department of Cardiovascular Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Mitsutoshi
authors.initials: M
authors.lastname: Kimura
authors.forename: Takashi
authors.initials: T
authors.lastname: Nishimura
authors.forename: Osamu
authors.initials: O
authors.lastname: Kinoshita
authors.forename: Koichi
authors.initials: K
authors.lastname: Kashiwa
authors.forename: Shunei
authors.initials: S
authors.lastname: Kyo
authors.forename: Minoru
authors.initials: M
authors.lastname: Ono
mesh_terms: D000328:Adult; D001783:Blood Flow Velocity / Q000502:physiology*; D001794:Blood Pressure / Q000502:physiology*; D005260:Female; D006350:Heart Valve Prosthesis; D006353:Heart-Assist Devices; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D011673:Pulsatile Flow / Q000502:physiology*
references.citation: J Cardiol. 2010 Sep;56(2):220-8
references.pmid: 20615667
references.citation: ASAIO J. 2010 May-Jun;56(3):186-93
references.pmid: 20449894
references.citation: Trans Am Soc Artif Intern Organs. 1984;30:550-5
references.pmid: 6442813
references.citation: J Am Coll Cardiol. 1991 Nov 15;18(6):1493-8
references.pmid: 1939951
references.citation: J Artif Organs. 2010 Jul;13(2):88-91
references.pmid: 20364287
references.citation: Circ J. 2011;75(1):121-8
references.pmid: 21116070
references.citation: ASAIO J. 2004 Nov-Dec;50(6):621-3
references.pmid: 15672799
references.citation: J Artif Organs. 2009;12(1):27-34
references.pmid: 19330502
references.citation: J Artif Organs. 2007;10(2):85-91
references.pmid: 17574510
references.citation: ASAIO J. 1998 Sep-Oct;44(5):M714-8
references.pmid: 9804529