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A Journal on Surgery
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
Chirurgia 2007 October;20(5):217-9
Intrathoracic implantation of a new pulsatile left ventricular assist devices for partial unloading of the heart: the VERSUS pump
Christiansen S. 1, Kwant P. B. 2, Rakhorst G. 3, Verkroost M. W. A. 4, Elstrodt J. 3, Autschbach R. 1
1 Department of Cardiothoracic Surgery, University of Aachen, Aachen, Germany
2 Helmholtz-Institute for Biomedical Engineering, University of Aachen, Aachen, Germany
3 BME-Artificial Organs, University of Groningen Groningen, The Netherlands
4 Department of Cardiothoracic Surgery, University of Nijmegen Nijmegen, The Netherlands
Aim. Currently available pulsatile left ventricular assist devices (LVAD) are of considerable size and not appropriate for intrathoracic implantation. Therefore, we developed a new and very small LVAD (called VERSUS pump) for partial unloading of the heart and intrathoracic implantation and report here on our first animal tests.
Methods. The VERSUS pump was implanted in three calves for seven days each with regular hemodynamic, echocardiographic, and laboratory examinations as well as thorough examinations of the pumps and inner organs for thrombotic material and/or embolic events. The inflow graft was anastomosed to the left atrial appendage and the outflow graft to the descending aorta. The pump was placed in the left pleural cavity. Pump flow was adjusted to 1.5-2.5 L/min for partial unloading of the heart.
Results. Arterial and pulmonary arterial pressures remained stable during the whole test period. Partial unloading of the heart led to a slight decrease of the left ventricular enddiastolic (13%) and endsystolic (12%) diameter as well as cardiac output (30%). Hemoglobin and the number of platelets decreased perioperatively (drop of 34 and 36%, respectively) and increased continuously thereafter. Free hemoglobin was not significantly enhanced in the postoperative course (increase of 4%). Examination of the inner organs revealed no thromboembolic infarctions or thrombotic material within the pump. Also technical failures were not observed.
Conclusion. This new pulsatile LVAD for intrathoracic implantation appears to be a very promising alternative for partial unloading of the left ventricle.