FOLLOWUP OF PATIENTS DISCHARGED WITH THE JARVIK 2000® HEART FOR LIFETIME USE

Abstract

The Jarvik 2000 FlowMaker™ is a miniature axial flow pump used to support the failing left ventricle. In Europe, 14 patients have been implanted for long term support using a post-auricular connector in 12 and abdominal cable in 2. All were males 25–72 years. 4 patients 13 idiopathic cardiomyopathy, 1 dermatomyositis) died in hospital, and 1 patient (amyloidosis) died at home. 9 patients were discharged and 8 (all idiopathic) are surviving at 1–19 months. One bridge to transplant patient (viral myocarditis) remains hospitalized in excellent condition awaiting a donor. So the 8 ongoing discharged patients mean survival is >B months [62–575 days], mean out of hospital time is >6 months [24–516 days], and mean time to discharge was under 6 weeks. There have been no pump failures, no controller failures, and no infections of the post-auricular connector. Thromboembolism was minor with 2 TIA's which resolved completely. With everyday use the cables and connectors have had few instances of damage, but when necessary they been easily replaced. Prior to discharge all patients were, 1) rehabilitated to NYHA class I or 11, 2) haemodynamically stable with the pump off for at least 1 minute, 3) infection free, 4)clinically anticoagulated with INR≥2, and 5) trained with equipment use and knowledgeable of emergency procedures. Following discharge patients report gradual continuing improvement in exercise tolerance and quality of life. They become quite independent, and four of the nine discharged patients have returned to work.