PMID- 19589689
OWN - NLM
STAT- MEDLINE
DCOM- 20110119
LR  - 20100203
IS  - 1873-734X (Electronic)
IS  - 1010-7940 (Linking)
VI  - 37
IP  - 2
DP  - 2010 Feb
TI  - Destination therapy with a rotary blood pump and novel power delivery.
PG  - 350-6
LID - 10.1016/j.ejcts.2009.03.071 [doi]
AB  - OBJECTIVE: We tested the hypothesis that a miniaturised axial flow pump with 
      infection-resistant power delivery could improve longevity and quality of life 
      (QOL) in advanced heart failure patients deemed unsuitable for transplantation. 
      METHODS: The study included all non-United States Jarvik 2000 patients (n=46), 
      where a skull-pedestal-based power line was employed with the intention of 
      long-term support. Patient age ranged from 29 to 80 years. Of the 46 patients, 42 
      were male. All were New York Heart Association (NYHA) IV predominantly with 
      idiopathic dilated (n=22) or ischaemic (n=18) cardiomyopathy. The experience 
      (2000-2008) included the learning curve of 10 centres. RESULTS: The internal 
      components are imperceptible. The power/control system is user friendly, allowing 
      excellent QOL. There has been no pump malfunction. The Kaplan-Meier survival 
      analysis is shown. The longest event-free survival is 7.5 years. Support exceeded 
      3 years in five cases. The cumulative experience exceeds 50 years. Three patients 
      were transplanted, and two pumps were replaced at 90 and 203 days. Nineteen cases 
      are ongoing (mean: 663 days), while 22 died during support (mean survival: 402 
      days), of which five from non-device-related diseases. Temporary local infection 
      occurred in three pedestals, and there has been no pump infection. Incidence of 
      thrombo-embolic events showed wide variation between centres. CONCLUSIONS: From 
      this learning-curve experience, both left ventricular assist device (LVAD) and 
      power delivery are reliable and promising for destination therapy. Early 
      mortality is similar to other studies and relates to the severity of illness. 
      Pump infection has not occurred and prolonged event-free survival is clearly 
      possible with expert medical management.
CI  - Copyright 2009. Published by Elsevier B.V.
FAU - Westaby, Stephen
AU  - Westaby S
AD  - Department of Cardiothoracic Surgery, John Radcliffe Hospital, Headley Way, 
      Headington, Oxford OX3 9DU, UK. swestaby@ahf.org.uk
FAU - Siegenthaler, Michael
AU  - Siegenthaler M
FAU - Beyersdorf, Friedhelm
AU  - Beyersdorf F
FAU - Massetti, Massimo
AU  - Massetti M
FAU - Pepper, John
AU  - Pepper J
FAU - Khayat, Andre
AU  - Khayat A
FAU - Hetzer, Roland
AU  - Hetzer R
FAU - Frazier, Oscar Howard
AU  - Frazier OH
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20090708
PL  - Germany
TA  - Eur J Cardiothorac Surg
JT  - European journal of cardio-thoracic surgery : official journal of the European 
      Association for Cardio-thoracic Surgery
JID - 8804069
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Assisted Circulation/instrumentation/*methods
MH  - Cohort Studies
MH  - Disease-Free Survival
MH  - Female
MH  - Heart Failure/*therapy
MH  - Heart Transplantation
MH  - *Heart-Assist Devices
MH  - Humans
MH  - Long-Term Care/methods
MH  - Male
MH  - Middle Aged
MH  - Miniaturization
MH  - Prosthesis Design
MH  - Thoracotomy/methods
EDAT- 2009/07/11 09:00
MHDA- 2011/01/20 06:00
CRDT- 2009/07/11 09:00
PHST- 2008/09/11 00:00 [received]
PHST- 2009/03/12 00:00 [revised]
PHST- 2009/03/17 00:00 [accepted]
PHST- 2009/07/11 09:00 [entrez]
PHST- 2009/07/11 09:00 [pubmed]
PHST- 2011/01/20 06:00 [medline]
AID - S1010-7940(09)00543-0 [pii]
AID - 10.1016/j.ejcts.2009.03.071 [doi]
PST - ppublish
SO  - Eur J Cardiothorac Surg. 2010 Feb;37(2):350-6. doi: 10.1016/j.ejcts.2009.03.071. 
      Epub 2009 Jul 8.