Complete Left Ventricular Bypass With a Paracorporeal Pump

Pierce, William S.; Brighton, J. A.; O'Bannon, W; Donachy, James H.; Phillips, Winfred M.; Landis, D. L.; White, William J.; Waldhausen, John A.

doi:10.1097/00000658-197410000-00006

Cited by 20 publications

(6 citation statements)

References 6 publications

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“…The initial development of ventricular assist devices (VADs) began in the 1970s as a permanent treatment option for end-stage heart failure [1,2]. However, from the mid 1980s, the focus of VAD development shifted to left ventricular support without heart resection, and left ventricular assist devices (LVADs) have since become a viable therapeutic approach as a bridge to cardiac transplantation (BTT) [3,4].…”

Section: Introductionmentioning

confidence: 99%

Current status of third-generation implantable left ventricular assist devices in Japan, Duraheart and HeartWare

Sawa

2014

Surg Today

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Recently, left ventricular assist devices (LVADs) have become a viable therapeutic approach as a bridge to cardiac transplantation, as well as destination therapy or as part of the bridge to recovery. In Japan, paracorporeal pneumatic devices are the only choice for such therapy, as implantable LVADs are not yet generally available due to device lag, which represents a serious problem in this field. Clinical trials of four different continuous-flow pumps, both axial and centrifugal flow types, were completed at about the same time, and two of those devices, DuraHeart and EVAHEART, have already been approved for use in Japan. Thus, reports of advanced treatment for severe heart failure with these devices are expected. The DuraHeart (Terumo Heart, Ann Arbor, MI, USA) and another device named the HeartWare (HeartWare Inc, Miami Lakes, FL, USA) are so-called third-generation devices, as they have achieved miniaturization and improvements in performance from the use of magnetic levitation. Based on our experiences from both clinical research and experimental use, we herein discuss the DuraHeart and HeartWare devices, with a focus on the clinical outcomes and management strategies. Because of the long waiting period for heart transplantation in Japan, these two devices are considered to have important roles in the near future for the treatment of severe heart failure, and a comprehensive strategy for LVAD therapy including such third-generation implantable devices is expected.

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Section: Introductionmentioning

confidence: 99%

Current status of third-generation implantable left ventricular assist devices in Japan, Duraheart and HeartWare

Sawa

2014

Surg Today

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“…The measurement of flow field velocities in left ventricular assist devices (LVAD) facilitates the identification of regions potentially causing thrombosis, clot formation and blood coagulation, and hemolysis [12]. The occurrence of both should be avoided to ensure long term ventricular support.…”

Section: Introductionmentioning

confidence: 99%

The Influence of Device Position on the Flow Within the Penn State 12 cc Pediatric Ventricular Assist Device

2012

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Ventricular assist devices are a commonly used heart failure therapy for adult patients as bridge-to-transplant or bridge-to-recovery tool. The application of adult ventricular assist devices in pediatric patients has led to increased thrombotic events. Therefore, we have been developing a pediatric ventricular assist device, the Penn State 12 cc PVAD. It is designed for patients with a body weight of 5 to 15 kg and has a stroke volume of 12 cc. Clot formation is the major concern. It is correlated to the coagulability of blood, the blood contacting materials and the fluid dynamics within the system. The intent is for the PVAD to be a long term therapy. Therefore, the system may be oriented in different positions according to the patient’s behavior. This study evaluates for the first time the impact of position on the flow patterns within the Penn State 12 cc PVAD, which may help to improve the PVAD design concerning chamber and ports geometries. The fluid dynamics are visualized by particle image velocimetry. The evaluation is based on inlet jet behavior and calculated wall shear rates. Vertical and horizontal model orientations are compared, both with a beat rate of 75, outlet pressures of 90/60 mmHg and a flow rate of 1.3 l/min. The results show a significant change of the inlet jet behavior and the development of a rotational flow pattern. Vertically, the inlet jet is strong along the wall. It initiates a rotational flow pattern with a wandering axis of rotation. In contrast, the horizontal model orientation results show a weaker inlet jet along the wall with a nearly constant center of rotation location, which can be correlated to a higher risk of thrombotic events. In addition high speed videography illustrates differences in the diaphragm motion during diastole. Diaphragm opening trajectories measurements determine no significant impact of the density of the blood analog fluids. Hence, the results correlate to human blood.

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“…Indeed, this regimen has reduced the occurrence of thromboembolism in our animals considerably. Pierce and coworkers, 30 Boretos et a1.,63 and Pierce 64 use heparin for the first five days and then go over to a similar regimen.…”

Section: Artificial Hearts and Assist Devicesmentioning

confidence: 99%

Blood at Artificial Organ Surfaces: Progress to Date as Stepping‐stones for the Future*

Kolff¹,

Stellwag²

1977

Annals of the New York Academy of Sciences

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Complete Left Ventricular Bypass With a Paracorporeal Pump

Cited by 20 publications

References 6 publications

Current status of third-generation implantable left ventricular assist devices in Japan, Duraheart and HeartWare

Current status of third-generation implantable left ventricular assist devices in Japan, Duraheart and HeartWare

The Influence of Device Position on the Flow Within the Penn State 12 cc Pediatric Ventricular Assist Device

Blood at Artificial Organ Surfaces: Progress to Date as Stepping‐stones for the Future*

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