Implantation of the Jarvik 2000 Heart

Abstract

The axial-flow cardiac assist pump is an innovative type of iml)lautable left ventricular assist system (LVAS) that offers a numl)cr of advantages over conventional, pulsatilc systems. The axial-flow pure I) is significantly smaller than coral)arable l)ulsatile iml)lantable pumps and requires no valvular mechanism. The constant flow of blood through the I)um I) mininfizes stasis anti continuously washes the inorganic surfaces, reducing the likelihood of device thrombosis. The constant flow also obviates the need for a coml)liance chamber, so venting is unnecessary. Because the axialflow immp is nonl)ulsatile, trauma related to movement of the drivelinc (an important potential source of infection) is significantly reduced. Whereas traditional LVASs necessitate a fairly extensive implant oI)eration, the axial-flow llUml ) is easier to implant, hcll)ing to minimize operative complications. As this LVAS has only 1 movable component, device reliability and durability are enhanced. The pump can be used to support chihlrcn and smaller aduhs, as well as adults of usual size. In contrast to conventional, 1)ulsatile LVASs, which are intended to capture the entire left ventricular outi)ut and, therefore, to serve as vcntricnlar rel)laccmcnt devices, the axial-flow pnm I) is best used as a true assist device. This article focuses on the Jarvik 2000 Heart (Jarvik Heart, Inc., New York, NY), an electrically I)owered LVAS that provides continuous flow from tlle left ventricle to tlle descending thoracic aorta. This pump is unique in that it can be placed within the left ventricle, thereby avoiding the rheologic problems (negative pressure stasis) associated with an inflow conduit. The Jarvik 2000 system, which has been described elsewhere FIG I. The Jarvik 2000 left ventricular assist system.