Artificial circulatory support with textured interior surfaces. A counterintuitive approach to minimizing thromboembolism.

Background: Although numerous left ventricular assist devices (LVADs) have been used clinically, frequent thromboembolic complications have been reported despite the smooth interior LVAD surfaces and systemic anticoagulant medication. In contrast, the Thermo Cardiosystems HeartMate 1000 IP LVAD has textured interior surfaces that are promptly covered by a densely adherent neointima. We hypothesize that elimination of a direct interface between prosthetic material and blood elements reduces the risk of peripheral embolization and minimizes the necessity for systemic anticoagulant medication.

A reliable bridge to cardiac transplantation: the TCI left ventricular assist device.

The Thermo Cardiosystems (TCI) HeartMate, a pneumatically driven, implantable left ventricular assist device, was designed for long-term support of the failing heart. Between February 1990 and August 1992, the HeartMate was implanted in 11 heart transplant candidates because of profound deterioration of left ventricular function. Patients had a mean cardiac index of 1.

Multicenter clinical evaluation of the HeartMate 1000 IP left ventricular assist device.

The Thermo Cardiosystems Inc (Woburn, MA) HeartMate 1000 IP left ventricular assist device (LVAD) has been evaluated as a bridge to transplantation in 34 patients for up to 324 days at seven clinical centers in the United States. Sixty-five percent of the patients underwent transplantation, 80% of whom were discharged from the hospital. Six additional control patients, transplant candidates who met the entrance criteria but who did not receive the device, were also included in the study.

Mediastinitis complicating successful mechanical bridge to heart transplantation.

A 22-year-old man with severe end-stage cardiomyopathy required placement of a left ventricular assist device. Purulent mediastinitis and peritonitis developed while the device was in place. The patient survived a prolonged course of treatment, with mediastinal and peritoneal irrigation and parenteral antibiotics, before undergoing a successful heart transplantation 12 weeks after placement of the left ventricular assist device.

Surgical complications in bridging to transplantation: the Thermo Cardiosystems LVAD.

Left ventricular assistance with a number of different devices has been used to successfully bridge patients to cardiac transplantation. Surgical complications or complications related to the device itself, however, may preclude transplantation or lead to death. We report our recent experience with the Thermo Cardiosystems model 14 "HeartMate" left ventricular assist device in 3 patients.