Richard J. Kaplon, MDa, Mehmet C. Oz, MDa, Pawel A

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Presentation transcript:

Miniature axial flow pump for ventricular assistance in children and small adults Richard J. Kaplon, MDa, Mehmet C. Oz, MDa, Pawel A. Kwiatkowski, MDa, Howard R. Levin, MDa, Aamir S. Shah, MDa, Robert K. Jarvik, MDb, Eric A. Rose, MDa The Journal of Thoracic and Cardiovascular Surgery Volume 111, Issue 1, Pages 13-18 (January 1996) DOI: 10.1016/S0022-5223(96)70396-3 Copyright © 1996 Mosby, Inc. Terms and Conditions

Fig. 1 Jarvik 2000 intraventricular axial flow assist device measures 1.8 cm in diameter by 5 cm in length and has displacement volume of 12 ml. Rotor is encased in titanium shell and is supported at each end by tiny blood-immersed ceramic bearing 1 mm in diameter. The Journal of Thoracic and Cardiovascular Surgery 1996 111, 13-18DOI: (10.1016/S0022-5223(96)70396-3) Copyright © 1996 Mosby, Inc. Terms and Conditions

Fig. 2 In vitro studies with Jarvik 2000 intraventricular assist device have demonstrated flow rates from 2 to 7 L/min in water-glycerol test solution with viscosity similar to that of blood. At normal operating speeds of 16,000 to 18,000 rpm, device produces flow rates from 3 to 6 L/min at 80 mm Hg mean aortic pressure. AoP, Aortic pressure; LVP, left ventricular pressure. The Journal of Thoracic and Cardiovascular Surgery 1996 111, 13-18DOI: (10.1016/S0022-5223(96)70396-3) Copyright © 1996 Mosby, Inc. Terms and Conditions

Fig. 3 Before placement of Jarvik 2000 intraventricular assist device, sheep were anemic with mean hematocrit (Hct) of 22.8% ± 3.8% (n = 7). During course of mechanical support, mean hematocrit values rose significantly to 30.5% ± 3.4% (p = 0.01). The Journal of Thoracic and Cardiovascular Surgery 1996 111, 13-18DOI: (10.1016/S0022-5223(96)70396-3) Copyright © 1996 Mosby, Inc. Terms and Conditions

Fig. 4 Except for early perioperative thrombocytosis, platelet counts were normal in all sheep (n = 7). None of sheep had thrombocytopenia at any time while supported by Jarvik 2000 intraventricular assist device. The Journal of Thoracic and Cardiovascular Surgery 1996 111, 13-18DOI: (10.1016/S0022-5223(96)70396-3) Copyright © 1996 Mosby, Inc. Terms and Conditions

Fig. 5 Mean bilirubin and creatinine levels were within normal limits for all sheep (n = 7) during mechanical support. The Journal of Thoracic and Cardiovascular Surgery 1996 111, 13-18DOI: (10.1016/S0022-5223(96)70396-3) Copyright © 1996 Mosby, Inc. Terms and Conditions

Fig. 6 Mean plasma free hemoglobin (Hgb) levels were insignificantly (p = 0.1) elevated in comparison with baseline levels for all sheep (n = 7) mechanically supported by Jarvik 2000 intraventricular assist device. The Journal of Thoracic and Cardiovascular Surgery 1996 111, 13-18DOI: (10.1016/S0022-5223(96)70396-3) Copyright © 1996 Mosby, Inc. Terms and Conditions

Fig. 7 Mean lactate dehydrogenase (LDH) levels were insignificantly (p = 0.1) elevated in comparison with baseline levels in those sheep tested while mechanically supported by Jarvik 2000 intraventricular assist device. The Journal of Thoracic and Cardiovascular Surgery 1996 111, 13-18DOI: (10.1016/S0022-5223(96)70396-3) Copyright © 1996 Mosby, Inc. Terms and Conditions

Fig. 8 Flow and pressure tracings recorded with Jarvik 2000 intraventricular assist device turned on and off showed that flow from device, in this model, was pulsatile in nature. This was probably function of varied preload to device resulting from contractility of normal native heart; at higher pump speeds, flow from device became nonpulsatile. When device was turned off, flow through Dacron graft was reversed as indicated by negative flow in flow tracing. This retrograde flow was tolerated by all animals. The Journal of Thoracic and Cardiovascular Surgery 1996 111, 13-18DOI: (10.1016/S0022-5223(96)70396-3) Copyright © 1996 Mosby, Inc. Terms and Conditions