|
|
||||||||
J Thorac Cardiovasc Surg 2007;134:199-203
© 2007 The American Association for Thoracic Surgery
Cardiothoracic Transplantation |
a Cardiothoracic Transplantation and Mechanical Circulatory Support, Royal Brompton & Harefield Hospital, London, UK
b National Heart and Lung Institute, Imperial College, London, UK.
Received for publication September 8, 2006; revisions received November 14, 2006; accepted for publication January 5, 2007. * Address for reprints: Dr Emma Birks, MRCP, PhD, Consultant in Transplant Cardiology and Mechanical Circulatory Support, Department of Cardiothoracic Transplantation and Mechanical Circulatory Support, Royal Brompton & Harefield Hospital, Hill End Road, Harefield, Middlesex, London, UK. (Email: e.birks{at}imperial.ac.uk).
Objective: Rotary axial flow pumps have several potential advantages and disadvantages over pulsatile pumps. The Jarvik 2000 is distinctive in being intracardiac. We report our experience in 22 patients.
Methods: The Jarvik 2000 was implanted in 15 men and 7 women. Mean age was 38.8 (range 23–59) years, preoperative diagnosis was dilated cardiomyopathy in 16, postpartum cardiomyopathy in 3, ischemic heart disease in 2, and chronic allograft failure in 1. Twenty-one patients were in New York Heart Association class IV, and 1 patient was in class III. Nineteen patients were on inotropic support, 6 were supported with an intra-aortic balloon pump, and 2 patients had been salvaged with a Centrimag (Levitronix) ventricular assist device. The median pulmonary vascular resistance was 3 Wood units; median pulmonary capillary wedge pressure was 26.6 mm Hg; and mean Cardiac Index was 1.5 L/min/m2.
Results: There were 2 early deaths and 6 late deaths. The average postoperative ventilation time and Intensive Treatment Unit stay was 2.2 and 10 days, respectively. One patient required a right ventricular assist device for short-term support and another for medium-term support. Seven patients were bridged to transplant, 3 had myocardial recovery, and 4 are ongoing. Mean and total duration of support was 280.5 and 6172 days, respectively. Driveline failures were noted in 3, but there were no pump infections or failure.
Conclusion: The Jarvik 2000 provides satisfactory intermediate-term results as a bridge to transplant or recovery. It appears to be associated with a low rate of serious driveline or pump infections and technical failure. However, bleeding complications due to the required anticoagulation treatment frequently occurred.
This article has been cited by other articles:
![]() |
J. W. Haft, F. D. Pagani, M. A. Romano, C. L. Leventhal, D. B. Dyke, and J. C. Matthews Short- and long-term survival of patients transferred to a tertiary care center on temporary extracorporeal circulatory support. Ann. Thorac. Surg., September 1, 2009; 88(3): 711 - 717. [Abstract] [Full Text] [PDF] |
||||
![]() |
C. Loffler, A. Straub, N. Bassler, K. Pernice, F. Beyersdorf, C. Bode, M. P. Siegenthaler, and K. Peter Evaluation of platelet activation in patients supported by the Jarvik 2000* high-rotational speed impeller ventricular assist device. J. Thorac. Cardiovasc. Surg., March 1, 2009; 137(3): 736 - 741. [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 |