Midterm experience with the Jarvik 2000 axial flow left ventricular assist device

J Thorac Cardiovasc Surg. 2007 Jul;134(1):199-203. doi: 10.1016/j.jtcvs.2007.01.002.

Abstract

Objective: Rotary axial flow pumps have several potential advantages and disadvantages over pulsatile pumps. The Jarvik 2000 is distinctive in being intracardiac. We report our experience in 22 patients.

Methods: The Jarvik 2000 was implanted in 15 men and 7 women. Mean age was 38.8 (range 23-59) years, preoperative diagnosis was dilated cardiomyopathy in 16, postpartum cardiomyopathy in 3, ischemic heart disease in 2, and chronic allograft failure in 1. Twenty-one patients were in New York Heart Association class IV, and 1 patient was in class III. Nineteen patients were on inotropic support, 6 were supported with an intra-aortic balloon pump, and 2 patients had been salvaged with a Centrimag (Levitronix) ventricular assist device. The median pulmonary vascular resistance was 3 Wood units; median pulmonary capillary wedge pressure was 26.6 mm Hg; and mean Cardiac Index was 1.5 L/min/m2.

Results: There were 2 early deaths and 6 late deaths. The average postoperative ventilation time and Intensive Treatment Unit stay was 2.2 and 10 days, respectively. One patient required a right ventricular assist device for short-term support and another for medium-term support. Seven patients were bridged to transplant, 3 had myocardial recovery, and 4 are ongoing. Mean and total duration of support was 280.5 and 6172 days, respectively. Driveline failures were noted in 3, but there were no pump infections or failure.

Conclusion: The Jarvik 2000 provides satisfactory intermediate-term results as a bridge to transplant or recovery. It appears to be associated with a low rate of serious driveline or pump infections and technical failure. However, bleeding complications due to the required anticoagulation treatment frequently occurred.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Anastomosis, Surgical / adverse effects
  • Disseminated Intravascular Coagulation / etiology
  • Equipment Failure Analysis
  • Female
  • Heart Ventricles / surgery*
  • Heart-Assist Devices / adverse effects*
  • Humans
  • Length of Stay
  • Male
  • Middle Aged
  • Multiple Organ Failure / etiology
  • Postoperative Care
  • Postoperative Hemorrhage / etiology
  • Prosthesis Design
  • Retrospective Studies
  • Sepsis / etiology
  • Surgical Wound Infection / etiology
  • Thrombosis / etiology