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(Circulation. 2002;105:2588.)
© 2002 American Heart Association, Inc.

Brief Rapid Communications

Circulatory Support for Long-Term Treatment of Heart Failure

Experience With an Intraventricular Continuous Flow Pump

Stephen Westaby, PhD, MS, FRCS; Adrian P. Banning, MD, MRCP; Satoshi Saito, MD, PhD; David W. Pigott, FRCA; Xu Y. Jin, MD, PhD; Pedro A. Catarino, FRCS; Desiree Robson, RN; Narain Moorjani, FRCS; Attila Kardos, MD, PhD; Philip A. Poole-Wilson, FRCP, MD; Robert Jarvik, MD; O.H. Frazier, MD

From the Oxford Heart Centre, Oxford, UK (S.W., A.P.B., S.S., D.W.P., X.Y.J., P.A.C., D.R., N.M., A.K.); National Heart and Lung Institute, London, UK (P.A.P.-W.); Jarvik Heart Inc, New York, NY (R.J.); and Texas Heart Institute, Houston (O.H.F.).

Reprint requests to Stephen Westaby, PhD, MS, FRCS, Oxford Heart Centre, Oxford, OX3 9DU, UK. E-Mail swestaby{at}AHF.org.uk

Background— A lifetime mechanical solution for advanced heart failure must be reliable, with a low risk of life-threatening complications. After extensive laboratory testing, we began clinical trials with an axial flow pump for long-term treatment of New York Heart Association class IV, transplant-ineligible patients.

Methods and Results— The Jarvik 2000 is a continuous flow device that is implanted in the apex of the left ventricle with offloading to the descending thoracic aorta. Skull-based percutaneous power delivery was derived from cochlear implant technology. We used this system in 4 patients with end-stage dilated cardiomyopathy. Exercise capacity, quality of life, device parameters, and native heart function were monitored serially. One patient died from right heart failure at 3 months. The other patients were discharged from hospital between 3 and 8 weeks postoperatively and are currently New York Heart Association I or II. Follow-up lasted between 9 and 20 months. There has been no device failure or hemolysis. Native heart function and quality of life were markedly improved.

Conclusions— The Jarvik 2000 is a true assist (rather than replacement) device that functions synergistically with the native left ventricle and provides excellent quality of life. Adverse events are infrequent. This blood pump may provide a mechanical solution for end-stage heart failure in the community.

Key Words: heart failure • heart-assist device • blood flow

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