From bench to bedside: Can the improvements in left ventricular assist device design mitigate adverse events and increase survival?

Tarzia, Vincenzo; Giammarco, Gabriele Di; Mauro, Michele Di; Bortolussi, Giacomo; Maccherini, Massimo; Tursi, V.; Maiani, Massimo; Bernazzali, Sonia; Marinelli, Daniele; Foschi, Massimiliano; Buratto, Edward; Bejko, Jonida; Gregori, Darío; Scuri, Silvia; Livi, Ugolino; Sani, Guido; Bottio, Tomaso; Gerosa, Gino

doi:10.1016/j.jtcvs.2015.09.107

Cited by 16 publications

(19 citation statements)

References 16 publications

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“…There has been an increase in the number of patients being supported on continuous flow left ventricular assist devices (LVADs) over the past 7 years . While the transition to continuous flow devices has resulted in improved mechanical durability and patient survival, longer support duration has increased the incidence of device‐related adverse events . In the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) after 6 months of LVAD support, more than half the patients experienced a major adverse event .…”

Section: Introductionmentioning

confidence: 99%

Risk factors for stroke on left ventricular assist devices

et al. 2018

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Section: Introductionmentioning

confidence: 99%

Risk factors for stroke on left ventricular assist devices

et al. 2018

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“…The two most innovative systems to avoid cable infections are: (1) the transcutaneous energy transmission (TET) system, which transfers energy via two coils, one under and the other over the skin; and (2) the Jarvik 2000 LVAD (Jarvik Heart Inc., NY), in which a retroauricular titanium pedestal is placed on the skull, thus providing a low infection rate [39,40]. The TET system was used in conjunction with the Arrow LionHeart (Arrow International, PA) as a pulsatile LVAD in an individual who survived for 3.5 years without skin complications [37].…”

Section: Discussionmentioning

confidence: 99%

Durable Continuous-Flow Mechanical Circulatory Support: State of the Art

Loforte

Botta

Boschi

et al. 2021

Hearts

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Implantable mechanical circulatory support (MCS) systems for ventricular assist device (VAD) therapy have emerged as an important strategy due to a shortage of donor organs for heart transplantation. A growing number of patients are receiving permanent assist devices, while fewer are undergoing heart transplantation (Htx). Continuous-flow (CF) pumps, as devices that can be permanently implanted, show promise for the treatment of both young and old patients with heart failure (HF). Further improvement of these devices will decrease adverse events, enable pulse modulation of continuous blood flow, and improve automatic remote monitoring. Ease of use for patients could also be improved. We herein report on the current state of the art regarding implantable CF pumps for use as MCS systems in the treatment of advanced refractory HF.

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“…Jarvik 2000 LVAD is a widely used device and it was originally conceived for left thoracotomy implantation on beating-heart through anastomosis onto the descending aorta. [9][10][11] Few reports are available regarding the clinical implications of LVAD--not only Jarvik 2000--outflow-graft anastomotic site and they mostly refer to single center experience with varying results. [12][13][14] However, no clinical studies have been reported to date for comparison of ascending versus descending aortic anastomosis in Jarvik 2000.…”

Section: Discussionmentioning

confidence: 99%

From bench to bedside: Impact of left ventricular assist device outflow conduit anastomosis position on outcome

et al. 2020

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Continuous flow left ventricular assist devices (LVADs) have become a valuable therapy for end‐stage heart failure. In vitro research highlighted a role of outflow cannula position on the pattern of blood flow in the aorta. However, the clinical effects of the alterations of flow remain unclear. We investigate short‐ and long‐term outcomes of patients implanted with Jarvik 2000 LVAD, according to the ascending (Group 1) versus descending (Group 2) outflow graft connection to the aorta in a multicenter study. From May 2008 to October 2014, 140 consecutive end‐stage heart failure patients underwent Jarvik 2000 LVAD implantation in 17 Italian centers. According with a preliminary multivariate analysis, we selected the 90 patients implanted in the four high‐volume centers to avoid bias (Group 1 n = 39, Group 2 n = 51). Among the groups, no differences were recorded in the hospital mortality and the main complications occurring after LVAD implantation were similar. In multivariable analysis, the ascending aorta outflow cannula position and higher creatinine at discharge were significant predictors for long‐term survival. Postimplant hemolysis was more pronounced in descending aorta outflow graft anastomosis. Outflow graft anastomosis to the ascending aorta is associated with better long‐term survival, independent of age and perfusion techniques, reflecting the previous in vitro results.

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From bench to bedside: Can the improvements in left ventricular assist device design mitigate adverse events and increase survival?

Abstract: Patients with the new pump configuration showed a better freedom from cardiovascular death and lower incidence of fatal stroke and right ventricular failure. Further studies are needed to prove the favorable impact of pump-enhanced fluid dynamics on long-term results.

Cited by 16 publications

References 16 publications

Risk factors for stroke on left ventricular assist devices

Risk factors for stroke on left ventricular assist devices

Durable Continuous-Flow Mechanical Circulatory Support: State of the Art

From bench to bedside: Impact of left ventricular assist device outflow conduit anastomosis position on outcome

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