Real World Experience with an Optimized Control Scheme for a Ventricular Assist Device

Steingräber, Robert; Kiesner, Matthias

doi:10.1515/cdbme-2020-3079

Cited by 2 publications

(2 citation statements)

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“…Unfortunately, the IKUS has a battery life of only 30 min and thus considerably limits patients' mobility (7). Focusing on this particular patient group, Berlin Heart GmbH has recently developed a novel electro-pneumatic mobile drive unit called EXCOR R Active (8), that has been especially designed for the operation of the paracorporeal system EXCOR R VAD and can be used for Abbreviations: BVAD, biventricular assist device; ECG, electrocardiogram; HHE, home healthcare environment; HQRL, healthrelated quality of life; HR, heart rate; INR, international normalized ratio; NT-proBNP, N-terminal prohormone of brain natriuretic peptide; LVAD, left ventricular assist device; OMT, optimal medical treatment; PedsQL, pediatric quality of life inventory; RVAD, right ventricular assist device; VAD, ventricular assist device.…”

Section: Introductionmentioning

confidence: 99%

“…Unfortunately, the IKUS has a battery life of only 30 min and thus considerably limits patients’ mobility ( 7 ). Focusing on this particular patient group, Berlin Heart GmbH has recently developed a novel electro-pneumatic mobile drive unit called EXCOR ® Active ( 8 ), that has been especially designed for the operation of the paracorporeal system EXCOR ® VAD and can be used for either univentricular assist (LVAD and RVAD, left and right ventricular assist device) or for biventricular assist (BVAD) ( 6 , 9 ). Both devices, the IKUS and EXCOR ® Active, can be used for both pediatric and adult patients with terminal cardiac insufficiency ( 9 ).…”

Section: Introductionmentioning

confidence: 99%

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Mobility and freedom of movement: A novel out-of-hospital treatment for pediatric patients with terminal cardiac insufficiency and a ventricular assist device

Rottermann

Dittrich

Dewald

et al. 2022

Front. Cardiovasc. Med.

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BackgroundDue to rapid medical and technological progress, more and more pediatric patients with terminal cardiac insufficiency are being implanted with a ventricular assist device as a bridge to transplant without legal approval for hospital discharge. EXCOR® Active is a recently developed mobile driving unit for the EXCOR® ventricular assist device (EXCOR® VAD) with a long-lasting battery life that can manage small blood pumps, offering improved mobility for pediatric patients. This study strives to elaborate the requirements necessary for a safe home healthcare environment (HHE) for pediatric patients on EXCOR® VAD powered by the EXCOR® Active driving unit.Materials and methodsPatient- and device-related preconditions (medical, ethical, psychological, technical, structural, organizational) were analyzed with regard to feasibility and safety in three individual patient cases. Included were pediatric patients with terminal cardiac insufficiency in a stable medical condition receiving in-hospital treatment with a univentricular or biventricular EXCOR® VAD powered by EXCOR® Active. Analysis was single-center, data was obtained 05/2020–02/2022.ResultsA total of three patients on EXCOR® VAD were identified for HHE treatment with the EXCOR® Active driving unit. Switch was performed safely and increased mobility led to improved psychomotor development and improved quality of life. No complications directly related to HHE-treatment occurred. One patient recently underwent an orthotopic heart transplant, one patient remains in HHE, and one patient died due to a complication not related to the HHE. Ethical approval for off-label use was obtained and patients and parents were given the required technical training and psychological support. Caregivers and medical professionals involved in the patients’ care at home were briefed intensely. Remote consultations were implemented and interdisciplinary in-hospital checks reduced to a long-term 4-week-scheme.ConclusionWhile it is challenging to discharge pediatric patients being treated with a paracorporeal ventricular assist device (EXCOR® VAD) from hospital, it is feasible and can be managed safely with the novel driving unit EXCOR® Active. A HHE may help to improve patients’ psychomotor development, offer normalized social contacts and strengthen both patients’ and parents’ physical and mental resources. Legal approval and another study with a larger sample size are warranted.

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Section: Introductionmentioning

confidence: 99%