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Hemodynamic Evaluation of the Jarvik 2000 Heart During Heart Failure
Jarvik Heart Inc., USA.
Jarvik Heart Inc., USA.
Jarvik Heart Inc., USA.
Linköping University, Department of Medicine and Care. Linköping University, Faculty of Health Sciences.
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2001 (English)In: ASAIO journal (1992), ISSN 1058-2916, E-ISSN 1538-943X, Vol. 46, no 2, 167- p.Article in journal (Refereed) Published
Abstract [en]

The Jarvik 2000 Heart is an axial flow left ventricular assist system designed for long-term circulatory support. Purpose: To assess the level of hemodynamic support provided by the Jarvik 2000 in an animal model, with acute, severe heart failure. Methods: Heart failure (HF) was induced in 5 calves by progressively ligating the LAD coronary artery. A continuous infusion of esmolol hydrochloride was given to maintain the stability of HF. Compared to normal baseline values, during heart failure CI decreased by 33% (p < 0.02), LAP increased by 16% (p < 0.03), and BP decreased by 28% (p < 0.13). Once stable HF was established, the pump was turned on, and hemodynamic measurements were obtained at pump speed settings that ranged from 8,000 to 12,000 rpm. Results: Selected, mean hemodynamic values are presented in the table, CI, LAP, and BP improved significantly (p < 0.05) at pump speeds >9000 rpm. Pulse pressure (PP) narrowed by 64% (p < 0.009), and the PAP remained unchanged.

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Blood flow in the femoral artery increased but was not statistically significant. Other hemodynamic parameters such as HR, SVR, PVR, and CVP did not change significantly. Conclusions: The Jarvik 2000 Heart can provide a level of cardiac output support that normalizes the CI and LAP, while maintaining some arterial pressure pulsatility during HF. Systemic perfusion is increased while the left heart is unloaded.

Place, publisher, year, edition, pages
Wolters Kluwer, 2001. Vol. 46, no 2, 167- p.
National Category
Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:liu:diva-13612OAI: oai:DiVA.org:liu-13612DiVA: diva2:21055
Note

The previous status of this article was Manuscript and the titel in manuskript form was Hemodynamic evaluation of the Jarvik 2000 Heart during heart failure in a calf model.

ASAIO Cardiovascular Abstracts.

Available from: 2001-06-12 Created: 2001-06-12 Last updated: 2016-05-04Bibliographically approved
In thesis
1. Management of patients treated with left ventricular assist devices: A clinical and experimental study
Open this publication in new window or tab >>Management of patients treated with left ventricular assist devices: A clinical and experimental study
2001 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

This thesis describes the management of patients treated with mechanical circulatory support devices for short- or long-term use. Twenty-four patients suffering from postcardiotomy heart failure were treated with a minimally invasive axial flow pump. The device was effective in unloading the failing left ventricle and in maintaining an adequate systemic circulation. The principles of perioperative monitoring, and pharmacological therapy are outlined. The pump was also used as an alternative to the heart-lung machine in conjunction with coronary artery bypass surgery. Together with a short-acting β-blocker, esmolol, the heart was decompressed and heart motion was reduced, facilitating bypass surgery on the beating heart. The anesthesiological considerations using this method are described.

An implantable left ventricular assist device was used as a bridge to heart transplantation in 10 patients. We were interested in assessing the possibility to establish such a treatment program at a non-transplanting center. A multidisciplinary approach was enabled thanks to the organization of our Heart Center and due the close collaboration with our transplant center at Lund University. As one of the first centers in Europe, we established a well-functioning program with good results. Nine out of 10 of the bridge patients, with treatment times varying between 53 to 873 days, survived pump treatment and were eventually transplanted. The device proved to be powerful enough to support the failing heart and enable rehabilitation of the patients. Outpatient management became simpler when using the electrical device with belt-worn batteries. The uncertain durability and the high risk of device-related complications are shortcomings that limit its potential for more permanent treatment of heart failure.

A new generation of small implantable axial blood flow pumps has therefore been developed. The principles of these pumps are based on the first generation axial flow pumps evaluated in this thesis. After several years of basic research and experimental studies, the first human implants have been performed. In the thesis, the hemodynamic effects of such a novel axial flow pump have been evaluated in an acute heart failure model. This technology holds great promise, both as a bridge to heart transplantation, and as a permanent circulatory support system.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2001. 79 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 677
Keyword
postcardiotomy heart failure, perioperative monitoring, coronary artery bypass, heart-assist devices, heart failure, congestive, ventricular dysfunction
National Category
Surgery
Identifiers
urn:nbn:se:liu:diva-5151 (URN)91-7219-969-5 (ISBN)
Public defence
2001-05-21, Berzeliussalen, Campus US, Linköpings universitet, Linköping, 00:00 (English)
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Supervisors
Note
On the day of the public defence the status of the article IV was: Submitted for publication.Available from: 2001-06-12 Created: 2001-06-12 Last updated: 2012-01-24Bibliographically approved

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Wårdell, Karin

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