A Portable Pneumatic Biventricular Driver for the Thoratec Ventricular Assist Device

Farrar, David J.; Buck, K.E.; Coulter, Jack H.; Kupa, Edward J.

doi:10.1097/00002480-199703000-00217

Cited by 40 publications

(6 citation statements)

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“…7 The ability of patients to resume mobility and everyday functions is perhaps one of the most important factors in rehabilitation and quality of life for patients on VAD support. Previous studies have clearly demonstrated an improvement in quality of life for those patients on VADs who were able to be discharged from the hospital.…”

Section: Discussionmentioning

confidence: 99%

Home Discharge Experience With the Thoratec TLC-II Portable Driver

Slaughter

Sobieski²,

Martin³

et al. 2007

ASAIO Journal

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With the growing success and expanded use of ventricular assist devices, home discharge with independent ambulation and self-care are now important issues. We describe our initial home discharge experience with the Thoratec TLC-II portable drive. Patients discharged home were required to have five outpatient excursions (three monitored) before discharge and were seen weekly after discharge. Between August 2000 and December 2004, 14 patients (average age, 57 years) were placed on the TLC-II portable driver. One patient on the TLC-II portable driver had left ventricular assist device removal after 50 days of support but before discharge. Thirteen patients were discharged from the hospital with average time at home of 62 days (range, 16 to 243 days). After discharge, the TLC-II portable driver was maintained in the auto mode at average settings of 78 beat rate, 5.1 L/min flow rate, 204 mm Hg ejection pressure, and -8.4 mm Hg fill vacuum. A total of 5852 alarms (average, 6.7 per day) were recorded with 2373 battery reminders (41%), 1922 occlusion alarms during sleep (33%), and 1461 no-fill signals (25%). There were no readmissions for device malfunction, emergency battery utilization or back-up unit use. These results demonstrate that the Thoratec TLC-II portable driver is safe, reliable, and can be effectively managed at home.

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Section: Discussionmentioning

confidence: 99%

Home Discharge Experience With the Thoratec TLC-II Portable Driver

Slaughter

Sobieski²,

Martin³

et al. 2007

ASAIO Journal

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“…The portable TLC-II driver allows greater independence and ambulation compared with the DDC, but, more importantly, it allows the patient to be discharged home while waiting for transplantation or recovery. 4,5 Currently, monitoring the TLC-II requires the docking station, which is mounted on a cart. Although effective, its size makes it cumbersome to move from one area of the hospital to another, and it can be intimidating to staff members.…”

Section: Discussionmentioning

confidence: 99%

The Thoratec Mobile Computer: Initial In-Hospital and Outpatient Experience

Sobieski¹,

George²,

Slaughter³

2004

ASAIO Journal

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The purpose of this study was to test the operational effectiveness of the Thoratec mobile computer for monitoring and adjusting the portable TLC-II pneumatic driver. The TLC-II portable driver is approved by the Food and Drug Administration for use with either the paracorporeal ventricular assist device (VAD) or the Implantable Thoratec VAD. Currently, data log/file retrieval, changing device parameters, and initial VAD set-up is done with the cart mounted docking station. Thoratec has developed a tablet computer to perform the same tasks. The tablet computer weighs 3.2 lbs and has a 10.4 inch display. The mobile computer was evaluated in the clinic and multiple hospital settings as a mobile substitute for the docking station. For 120 consecutive days, the tablet computer was used exclusively for data file retrieval, changing device parameters, and initial VAD set up of the TLC-II portable drivers. Five patients, four paracorporeal VAD and one Implantable Thoratec VAD, using eight TLC-II portable drivers were evaluated. All patients were discharged home and followed as outpatients. The tablet computer was used by the VAD coordinator, two nurse clinicians, a perfusionist, and a research assistant. A total of 59 individual uses were performed (data retrieval, 46; parameter changes, 5; initial VAD set up, 8). Data were successfully obtained in all cases. Documentation of programmed settings and driver operation was achieved without difficulty. ASAIO Journal 2004; 50:373-375.The Thoratec ventricular assist device (VAD) system is a pneumatically driven, pulsatile pump designed to operate with either the Dual Drive Console (DDC) 1 (Figure 1) or the TLC-II portable driver 2 (Figure 2). The TLC-II portable driver was recently approved by the Food and Drug Administration (FDA) for in-hospital use and home discharge. The TLC-II portable driver can be used with patients supported by either the paracorporeal VAD (PVAD) or the Implantable VAD system (IVAD) (The IVAD is currently undergoing FDA review for approval). Whereas the TLC-II driver itself contains computerized components, it requires an additional computer control system for initial set up, data retrieval, and any changes to the VAD parameters. The docking station (Figure 3) is currently the interface used most frequently by centers with the TLC-II driver. The docking station is mounted on a cart and contains a storage area for two TLC-II drivers below, a battery charger, and a touch screen computer, which is attached to the top of the cart. The docking station, which stands 44 inches high and weighs 73 lbs, can be difficult to relocate from place to place within the hospital setting and especially to an outpatient clinic.The Thoratec Mobile Computer (Figure 4) was designed as a portable alternative to the docking station. 3 The mobile computer is a flat panel tablet computer, which is easy to transport. We evaluated its effectiveness in-hospital as well as in the outpatient setting compared with the standard docking station.

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“…This solenoid drive system was used to actuate a pair of preloaded beam springs that directly coupled to a dual pusher-plate blood pump, producing high starting forces and constant pump pressures through repeated ejection strokes. With this technology operating in combination with external plug-ins that included portable and rechargeable lithium-ion, nickel metal hybrid, or lead acid gel batteries, a level of patient mobility similar to that afforded by battery-powered devices available today was achieved [88,89]. However, this drive system was limited not only by requiring patients to carry around external hardware like charging stations, battery packs, and emergency back-up systems in a backpack, but also by the anxiety produced by having to charge batteries every few hours [88,89].…”

Section: Innovations For Effective Long-term Cardiac Supportmentioning

confidence: 99%

Cardiac Assist Devices: Early Concepts, Current Technologies, and Future Innovations

Han

Trumble

2019

Bioengineering

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Congestive heart failure (CHF) is a debilitating condition that afflicts tens of millions of people worldwide and is responsible for more deaths each year than all cancers combined. Because donor hearts for transplantation are in short supply, a safe and durable means of mechanical circulatory support could extend the lives and reduce the suffering of millions. But while the profusion of blood pumps available to clinicians in 2019 tend to work extremely well in the short term (hours to weeks/months), every long-term cardiac assist device on the market today is limited by the same two problems: infections caused by percutaneous drivelines and thrombotic events associated with the use of blood-contacting surfaces. A fundamental change in device design is needed to address both these problems and ultimately make a device that can support the heart indefinitely. Toward that end, several groups are currently developing devices without blood-contacting surfaces and/or extracorporeal power sources with the aim of providing a safe, tether-free means to support the failing heart over extended periods of time.

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A Portable Pneumatic Biventricular Driver for the Thoratec Ventricular Assist Device

Cited by 40 publications

References 0 publications

Home Discharge Experience With the Thoratec TLC-II Portable Driver

Home Discharge Experience With the Thoratec TLC-II Portable Driver

The Thoratec Mobile Computer: Initial In-Hospital and Outpatient Experience

Cardiac Assist Devices: Early Concepts, Current Technologies, and Future Innovations

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