Initial clinical experience with the Jarvik 2000 implantable axial-flow left ventricular assist system.

Abstract

In this issue of Circulation , Frazier et al1 report their initial clinical experience with the Jarvik 2000 implantable axial-flow left ventricular (LV) assist system. This report is gratifying to me for several reasons. First, I have been involved in the development of devices to replace or assist the failing heart since the 1960s.2 I am also proud that the initial clinical work with this device was spearheaded by my colleague, Bud Frazier, who has worked tirelessly in this field since he was a medical student. Most important, however, is that this work gives hope to the 1 million patients with NYHA class III or IV heart failure who either die or suffer significant morbidity from their disease every year.3 New medications have helped delay the inevitable for some patients; however, a cure for chronic heart failure remains elusive. As heart failure worsens, medications become ineffective in treating the low contractility and pulmonary venous stasis that result from the increased dilatation of the heart. For patients with serious heart failure, the only hope is to unload the ventricle and augment the failing heart’s inadequate blood delivery. The Jarvik 2000 can do just that. See p 2855 The Jarvik 2000 works differently than many other left ventricular assist devices (LVADs). Most of the LVADs currently in use were created as a result of an initiative by the National Heart, Lung, and Blood Institute (NHLBI) to develop a totally implantable long-term heart assist system. In 19774 and 1980,5 requests for proposals (RFPs) ultimately …