DuraHeart magnetically levitated centrifugal left ventricular assist system for advanced heart failure patients.

The implantable left ventricular assist system (LVAS) using pulsatile pump technology has become an established therapeutic option for advanced heart failure patients. However, there have been technological limitations in some older designs, including a high incidence of infection and mechanical failures associated with moving parts, and the large size of both implantable pump and percutaneous cable. A smaller rotary blood pump emerged as a possible alternative to a large pulsatile pump to overcome some of these limitations.

Implantable left ventricular assist system.

The first clinical application of the first-generation pulsatile implantable left ventricular assist system (LVAS) was in the mid 1980 s as a bridge to transplantation and contributed to an advancement of this field from a clinical experiment to an established therapeutic option for treating advanced heart failure patients. However, there have been technological limitations that have surfaced as longer-term experience has been gained. These include a high incidence of thromboembolic complications, infection, mechanical failures associated with moving parts, and the large size of both implantable pump and percutaneous cable.

European experience of DuraHeart magnetically levitated centrifugal left ventricular assist system.

Objective: The DuraHeart (Terumo Heart, Inc., Ann Arbor, Michigan, USA) is the world's first approved magnetically levitated centrifugal left ventricular assist system designed for long-term circulatory support. We report the clinical outcomes of 68 patients implanted with the DuraHeart as a bridge to cardiac transplantation in Europe.

Implantation technique for the DuraHeart left ventricular assist system.

The DuraHeart is a centrifugal pump with a magnetically levitated impeller. We implant the DuraHeart blood pump, which is 72 mm in external diameter and 45 mm in height, in a preperitoneal pocket in the left upper abdomen. An apical cuff is sutured to the apical hole in the left ventricular apex with 12 mattress sutures of 3-0 Prolene pledgeted with Dacron felt.

The DuraHeart VAD, a magnetically levitated centrifugal pump: the University of Vienna bridge-to-transplant experience.

Background: The clinical application of the DuraHeart (Terumo Heart Inc, USA) has begun in Europe as a clinical trial of a third-generation implantable centrifugal blood pump. Four successful clinical implants are presented.

Methods And Results: Four male patients had end-stage left heart failure and received a DuraHeart VAD as a left ventricular assist device for bridge-to-transplantation.

[Implantable artificial heart].

Heart transplants have been decreasing globally due to the lack of available donor hearts. As a result, the increased use of artificial hearts is anticipated as an alternative therapy. Although biocompatibility issues, such as thrombus formation/thromboembolism and infection, are still the main cause of mortality associated with artificial hearts, more than 20 different types are now clinically available after a half-century of development and experimental trials.

Mechanical circulatory support devices (MCSD) in Japan: current status and future directions.

The current status and future directions of mechanical circulatory support devices (MCSDs) in Japan are reviewed. Currently used clinical MCSDs, both domestic and imported systems and continuous flow devices that are coming into the clinical arena are emphasized. Clinical MCSDs include the extracorporeal pulsatile Toyobo and Zeon systems and the implantable Novacor and HeartMate I VE.

Effect of pump flow mode of novel left ventricular assist device upon end organ perfusion in dogs with doxorubicin induced heart failure.

End organ effects of nonpulsatile (NP) and pulsatile (P) left ventricular assist device (LVAD) flow were compared in a canine model of doxorubicin-induced heart failure. After heart failure induction, a prototype bimodal LVAD was implanted. Hemodynamics, cardiac dimensions, and myocardial metabolism were monitored with the LVAD off (baseline) and on (in NP and P modes at 70% or 100% power).

End-organ function during chronic nonpulsatile circulation.

Background: Evolving blood pump technology has produced user-friendly continuous flow left ventricular assist devices, but uncertainty exists about the safety of chronic nonpulsatile circulation. We established consistently nonpulsatile blood flow in a sheep model using the Terumo magnetically suspended centrifugal pump. We then compared end-organ function between pulseless and control animals.

[Left ventricular assist system with a magnetically levitated impeller technology].

After the accumulation of clinical experience with the current generation of pulsatile implantable left ventricular assist systems (LVAS), these devices have demonstrated major limitations: high incidence of thromboembolic complications; large size; high infection rate; and limited long-term durability. To address the limitations of current-generation LVAS, second- and third-generation LVAS utilizing rotary blood pump technology are currently undergoing clinical trials and the final stage of product development. Among them, the rotary blood pump with a magnetically levitated impeller is one of the most promising pumps for long-term circulatory assist.