Compact, reliable ventricular assist device as a bridge to recovery or for semipermanent use.

Abstract

The magnetically suspended centrifugal pump has gained attention as an implantable ventricular assist device for long-term use. We report recovery-oriented pump operation and results of a chronic animal experiment. In an acute experiment in 8 sheep having microspheres injected to induce heart failure, left ventricular assist was implemented by 2 inflow cannulas, 1 each in the left atrium and left ventricle. The pressure-volume loop of the left ventricle and myocardial oxygen consumption were measured varying the assist rate. The chronic animal experiment used 10 sheep whose native heart was kept intact. Continuous hemodynamic monitoring and periodic blood sampling were conducted. In the acute study, myocardial oxygen consumption decreased proportionally with increasing assist rate in left atrial drainage, but was significantly less at a 100% assist rate in left ventricular drainage. External work in left ventricular drainage did not decrease until a 75% assist rate, suggesting that the left ventricle shape and size were maintained despite decreased myocardial oxygen consumption. In the chronic experiment, the pumping duration was 14 to 248 days. No thrombi or emboli in the pump or any major organ were found in sacrificed sheep after living more than 100 days. Hepatic and renal function were within an almost normal range throughout the experiment. Left ventricular blood drainage effectively reduced oxygen consumption, maintaining the shape of the left ventricle. The magnetically suspended centrifugal pump is suitable for recovery of a failing heart or semipermanent use.