An advanced universal circulatory assist device for left and right ventricular support: First report of an acute in vivo implantCentral MessagePerspective

Takuma Miyamoto, MD, PhD; Yuichiro Kado, MD, PhD; David J. Horvath, MSME; Barry D. Kuban, BS; Shiva Sale, MD; Kiyotaka Fukamachi, MD, PhD; Jamshid H. Karimov, MD, PhD

JTCVS Open (Sep 2020)

An advanced universal circulatory assist device for left and right ventricular support: First report of an acute in vivo implantCentral MessagePerspective

Takuma Miyamoto, MD, PhD,
Yuichiro Kado, MD, PhD,
David J. Horvath, MSME,
Barry D. Kuban, BS,
Shiva Sale, MD,
Kiyotaka Fukamachi, MD, PhD,
Jamshid H. Karimov, MD, PhD

Affiliations

Takuma Miyamoto, MD, PhD: Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
Yuichiro Kado, MD, PhD: Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
David J. Horvath, MSME: R1 Engineering, Euclid, Ohio
Barry D. Kuban, BS: Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio; Medical Device Solutions, Cleveland Clinic, Cleveland, Ohio
Shiva Sale, MD: Department of Cardiothoracic Anesthesiology, Cleveland Clinic, Cleveland, Ohio
Kiyotaka Fukamachi, MD, PhD: Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
Jamshid H. Karimov, MD, PhD: Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio; Address for reprints: Jamshid H. Karimov, MD, PhD, Department of Biomedical Engineering, Cleveland Clinic, 9500 Euclid Ave/ND20, Cleveland, OH 44195.

Journal volume & issue: Vol. 3
pp. 140 – 148

Abstract

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Background: The Advanced ventricular assist device (Advanced VAD) is designed as a universal pump intended to prevent backflow in the event of pump stoppage, to maintain physiological pulse pressure, and to be used as both a left and right VAD. The purpose of this study was to evaluate the performance of the Advanced VAD as both a left and right VAD in an acute in vivo study in calves. Methods: The Advanced VAD was implanted through a median sternotomy in 5 healthy calves (weight, 71.4-91.2 kg) as a left VAD (n = 3) or a right VAD (n = 2). After implantation, hemodynamic parameters, including general performance and pump stoppage, were evaluated. Results: The Advanced VAD was successfully implanted as a left and right VAD without cardiopulmonary bypass. The speed range of the Advanced VAD was 2500 to 3500 rpm as a left VAD and 2000 to 2500 rpm as a right VAD. Up to 4.3 L/min was achieved for both left and right VAD configurations. To demonstrate the automatic shut-off feature, the pump was stopped without clamping the outflow graft. The outflow graft was then clamped, which produced no significant changes in the arterial pressure waveform. The pulse pressures under the left VAD configuration were 38 mm Hg, 17 mm Hg, 14 mm Hg, and 16 mm Hg at baseline, 2500 rpm, 3000 rpm, and 3500 rpm, respectively. Conclusions: This acute in vivo study demonstrated the pump performance, anatomical fitting as both left VAD and right VAD, and regurgitant flow shut-off feature of the Advanced VAD.

Published in JTCVS Open

ISSN: 2666-2736 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the circulatory (Cardiovascular) system; Medicine: Surgery
Website: https://www.journals.elsevier.com/jtcvs-open

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