OC07 CAN WE USE THE NEW INFANT JARVIK 2015 IN PATIENTS LESS THAN 8KG? A SIMULATION STUDY

Abstract

Objective: to study test the feasibility of implanting the Infant Jarvik 2015 in patients lower than 8 kg. Methods: The LVAD was tested in a hybrid simulator of the cardiovascular system reproducing specific haemodynamic for different patients weight (2–8 kg). For each weight, we tested the LVAD sensitivity to circulatory parameters (pheripheral resistance, left and right ventricular elastances, heart rate and heart filling) repeating for each experiment a pump ramp (10000–18000 rpm). Results: The increment of the pump speed causes a decrement (increment) of the left (right) atrial pressure, an increment (decrement) of the arterial systemic (pulmonary) pressure, an increment of the right ventricular pressure, a decrement (increment) of the left (right) ventricular volume, a decrement of the left ventricular cardiac output, an increment of the LVAD output and an increment of the right ventricular cardiac output (total cardiac output). Suction was observed for lower weight patients and for higher pump speed in the case of vasodilation, left ventricular recovery, bradycardia, right ventricular failure and left ventricular hypertrophy, while backflow was observed only in the case of left ventricular recovery at lower pump speed. Conclusions: the use of a hybrid circulatory permits to test innovative VAD and the sensitivity of the pump to different circulatory parameters. In this specific application, the Infant Jarvik 2015 was suitable for the implantation in lower weight patients because of the stability respect to the cardiocirculatory changes (low frequency of suction and backflow) and because of the capability of the device in maintaining an adequate patients haemodynamics.