| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
J Thorac Cardiovasc Surg 2002;123:977-983
© 2002 The American Association for Thoracic Surgery
Evolving Technology (ET) |
From the Oxford Heart Centre,a Oxford, and The Heart Hospital, London, United Kingdom; Jarvik Heart Corp,b New York, NY; Texas Heart Institute,c Houston, Tex; and Department of Otolaryngology,d Radcliffe Infirmary, Oxford, United Kingdom.
Supported by charitable donations from the National Heart Research Fund and the Artificial Heart Fund, UK. Robert Jarvik, MD, is the chief executive of Jarvik Heart Inc. None of the other investigators has a financial interest in the company.
12/1/121045doi:10.1067/mtc.2002.121045 Address for reprints: Stephen Westaby, PhD, FRCS, MS, Oxford Heart Centre, John Radcliffe Hospital, Headington, Oxford OX3 9DU, United Kingdom (E-mail: swestaby{at}AHF.org.uk).
Objective: Percutaneous driveline infection continues to detract from both quality and length of life in patients with a left ventricular assist device. We have pursued an alternative route by using a skull-mounted percutaneous pedestal similar to cochlear implant technology. We have now used this method in patients implanted with the Jarvik 2000 heart (Jarvik Heart, Inc, New York, NY) as destination therapy for end-stage (New York Heart Association class IV) heart failure.
Methods: Four men with cardiomyopathy aged 61 to 72 years received the Jarvik 2000 heart with postauricular power delivery for permanent mechanical circulatory support. The power cable was brought through the second posterior intercostal space and routed through the neck to a percutaneous titanium implant screwed to the skull. This joins with the cable to the external controller and battery.
Results: In 3 patients the pedestal healed well and remained free from infection up to 1 year. The system was user friendly, and the whole external apparatus is exchangeable. The second patient had a subdural hematoma. This caused us to improve the preparation and modify the implant procedure.
Conclusion: For widespread use, permanent implantable circulatory support requires a reliable, user-friendly device with freedom from powerline infection. Our early experience with the Jarvik 2000 heart suggests that rigid fixation and the vascularity of scalp skin promote healing and reduce the risk of driveline infection.
This article has been cited by other articles:
|
|
 |
|
  A. J. Clegg, D. A. Scott, E. Loveman, J. L. Colquitt, P. Royle, and J. Bryant Clinical and cost-effectiveness of left ventricular assist devices as a bridge to heart transplantation for people with end-stage heart failure: a systematic review and economic evaluation Eur. Heart J., December 2, 2006; 27(24): 2929 - 2938. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Westaby, O.H. Frazier, and A. Banning Six years of continuous mechanical circulatory support. N. Engl. J. Med., July 20, 2006; 355(3): 325 - 327. [Full Text] [PDF]
|
|
|
|
 |
|
 M. P. Siegenthaler, O.H. Frazier, F. Beyersdorf, J. Martin, H. Laks, J. Elefteriades, A. Khaghani, U. Kjellman, B. Koul, J. Pepper, et al. Mechanical reliability of the jarvik 2000 heart. Ann. Thorac. Surg., May 1, 2006; 81(5): 1752 - 1759. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. P. Siegenthaler, S. Westaby, O.H. Frazier, J. Martin, A. Banning, D. Robson, J. Pepper, P. Poole-Wilson, and F. Beyersdorf Advanced heart failure: feasibility study of long-term continuous axial flow pump support Eur. Heart J., May 2, 2005; 26(10): 1031 - 1038. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. J. Myers, K. Robertson, T. Pool, N. Shah, I. Gregoric, and O. H. Frazier Continuous flow pumps and total artificial hearts: management issues Ann. Thorac. Surg., June 1, 2003; 75(90060): S79 - 85. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
