Circulation, Vol 89, 2908-2914, Copyright © 1994 by American Heart Association
OH Frazier
This report describes the first long-term (505-day) application of the
vented electric (VE) HeartMate left ventricular assist device (LVAD)
(Thermo Cardiosystems, Inc). The device consists of an abdominally placed,
battery-powered titanium blood pump that, in contrast to earlier
pneumatically powered systems, allows patients untethered freedom of
movement. The batteries last 5 to 8 hours and can be changed on a rotating
basis indefinitely. The patient, a 33-year-old man (90 kg, blood type O)
with idiopathic cardiomyopathy, experienced end-organ heart failure (New
York Heart Association [NYHA] class IV) while he was awaiting heart
transplantation. When his hemodynamic criteria met those outlined in the
protocol, we implanted the VE-LVAD as a bridge to transplantation. The
patient was supported by the device for more than 16 months. His cardiac
status returned to NYHA class I, and he was eventually allowed to take day
trips outside the hospital as he awaited transplantation. The VE-LVAD
enabled the patient to participate in activities such as eating in
restaurants, going to movies, and practicing basketball shots.
Unfortunately, the patient died suddenly due to a neurological
thromboembolic event that occurred on day 503 of VE-LVAD support. The
VE-LVAD improved native left ventricular function by chronic unloading, and
ventricular remodeling resulted in a more normal configuration
anatomically, physiologically, and ultimately, histologically and
pathologically.
ARTICLES
First use of an untethered, vented electric left ventricular assist device for long-term support [published erratum appears in Circulation 1995 Jun 15;91(12):3026]
Division of Cardiopulmonary Transplantation, Texas Heart Institute, St Luke's Episcopal Hospital, Houston 77225-0345.
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