RSS-Feed abonnieren
DOI: 10.1055/s-0029-1240685
© Georg Thieme Verlag KG Stuttgart · New York
Clinical Experience with the VentrAssist Left Ventricular Assist Device
Publikationsverlauf
Publikationsdatum:
25. Januar 2010 (online)
Abstract
Introduction: Left ventricular mechanical assist device (LVAD) support is well established as a bridge to transplantation and as an alternative to transplantation in patients with end-stage heart failure. There are currently various LVAD systems available based on different types of pump technology. We present the VentrAssist® LVAD, a centrifugal pump, and focus on a surgical implantation technique that may help reduce the complications typically associated with VAD surgery. Methods and Results: 412 patients underwent VentrAssist LVAD® implantation between June 2003 and January 2009 worldwide. The overall rate of success was 81 % (i.e., ongoing, HTX, or recovery). Interestingly hemolysis is greatly reduced with this intracorporeal centrifugal LVAD compared to other VAD systems with other pump designs. Our surgical implantation technique and strategy may contribute to reducing complications. Conclusion: The VentrAssist® is a powerful and effective LVAD; its use can considerably reduce hemolysis. Long-term follow-up is necessary to determine whether the VentrAssist® is appropriate as a bridge to transplant as well as feasible for long-term application.
Key words
assist device - hemolysis
References
- 1 Kamiya H, Koch A, Sack F U, Akhyari P, Remppis A, Dengler T J, Karck M, Lichtenberg A. Who needs ‘bridge to transplantation in the presence of the Eurotransplant high-urgency heart transplantation program?. Eur J Cardiothorac Surg. 2008; 34 (6) 1129-1133
- 2 Martin J, Siegenthaler M P, Friesewinkel O, Fader T, van de Loo A, Trummer G, Berchtold-Herz M, Beyersdorf F. Implantable left ventricular assist device for the treatment of pulmonary hypertension in candidates for orthotopic heart transplantation – a preliminary study. Eur J Cardiothorac Surg. 2004; 25 (6) 971-977
- 3 Zimpfer D, Zrunek P, Sandner S, Schima H, Grimm M, Zuckermann A, Wolner E, Wieselthaler G. Post-transplant survival after lowering fixed pulmonary hypertension using left ventricular assist devices. Eur J Cardiothorac Surg. 2007; 31 (4) 698-702
- 4 Lietz K, Long J W, Kfoury A G, Slaughter M S, Silver M A, Milano C A, Rogers J G, Naka Y, Mancini D, Miller L W. Outcomes of left ventricular assist device implantation as destination therapy in the post-REMATCH era: implications for patient selection. Circulation. 2007; 116 (5) 497-505
- 5 Sandner S E, Zimpfer D, Zrunek P, Rajek A, Schima H, Dunkler D, Zuckermann A O, Wieselthaler G M. Age and outcome after continuous-flow left ventricular assist device implantation as bridge to transplantation. J Heart Lung Transplant. 2009; 28 (4) 367-372
- 6 Esmore D S, Kaye D, Salamonsen R, Buckland M, Begg J R, Negri J, Ayre P, Woodard J, Rosenfeldt F L. Initial clinical experience with the VentrAssist left ventricular assist device: the pilot trial. J Heart Lung Transplant. 2008; 27 (5) 479-485
- 7 Kamdar F, Boyle A, Liao K, Colvin-Adams M, Joyce L, John R. Effects of centrifugal, axial, and pulsatile left ventricular assist device support on end-organ function in heart failure patients. J Heart Lung Transplant. 2009; 28 (4) 352-359
-
8
Strüber M, Sander K, Lahpor J, Ahn H, Litzler P Y, Drakos S G, Musumeci F, Schlensak C, Friedrich I, Gustafsson R, Oertel F, Leprince P.
HeartMate II left ventricular assist device; early European experience.
Eur J Cardiothorac Surg.
2008;
34 (2)
289-294
, Epub 2008 Jun 20
- 9 Watterson P A, Woodard J C, Ramsden V S, Reizes J A. VentrAssist hydrodynamically suspended, open, centrifugal blood pump. Artif Organs. 2000; 24 (6) 475-477
- 10 Tansley G, Vidakovic S, Reizes J. Fluid dynamic characteristics of the VentrAssist rotary blood pump. Artif Organs. 2000; 24 (6) 483-487
- 11 Heilmann C, Geisen U, Benk C, Berchtold-Herz M, Trummer G, Schlensak C, Zieger B, Beyersdorf F. Haemolysis in patients with ventricular assist devices: major differences between systems. Eur J Cardiothorac Surg. 2009; 36 (3) 580-584
- 12 Esmore D, Spratt P, Larbalestier R, Tsui S, Fiane A, Ruygrok P, Meyers D, Woodard J. VentrAssist left ventricular assist device: clinical trial results and clinical development plan update. Eur J Cardiothorac Surg. 2007; 32 (5) 735-744
- 13 Esmore D S, Kaye D, Salamonsen R, Buckland M, Rowland M, Negri J, Rowley Y, Woodard J, Begg J R, Ayre P, Rosenfeldt F L. First clinical implant of the VentrAssist left ventricular assist system as destination therapy for end-stage heart failure. J Heart Lung Transplant. 2005; 24 (8) 1150-1154
Christian Schlensak, MD, PhD
Department of Cardiovascular Surgery
University Hospital Freiburg
Hugstetterstraße 55
79106 Freiburg
Germany
Telefon: + 49 76 12 70 27 71
Fax: + 49 76 12 70 93 32
eMail: christian.schlensak@uniklinik-freiburg.de