Circulatory assistance with a permanent implantable IABP: initial human experience

Area of Science:

• Cardiovascular Medicine
• Biomedical Engineering
• Surgical Technology

Background:

• End-stage cardiomyopathy presents significant challenges in heart failure management.
• The intra-aortic balloon pump (IABP) is a temporary circulatory assist device.
• The Kantrowitz CardioVAD (KCV) is an electrically powered, pneumatically driven device designed for diastolic augmentation and systolic unloading.

Purpose of the Study:

• To evaluate the feasibility and efficacy of the Kantrowitz CardioVAD (KCV) in patients with end-stage cardiomyopathy.
• To assess the hemodynamic and functional improvements provided by the KCV.

Main Methods:

• A feasibility study involving 5 male patients (age 59-73) with end-stage cardiomyopathy refractory to medical treatment.
• Patients demonstrated hemodynamic improvement on an intra-aortic balloon pump (IABP) prior to enrollment.
• The KCV was surgically implanted in the descending thoracic aorta.

Main Results:

• Successful implantation of the KCV was achieved in the majority of patients.
• At 1 month post-implantation, cardiac index increased significantly (1.7 to 2.6 L/min/m²).
• Significant reductions were observed in creatinine, pulmonary capillary wedge pressure (PCWP), and right atrial pressure (RA).
• New York Heart Association (NYHA) class improved from IV to II.
• The device was used intermittently without thromboembolic complications, and no anticoagulation was required.
• Two patients were discharged home.

Conclusions:

• The Kantrowitz CardioVAD (KCV) is successfully implantable in end-stage heart failure patients.
• The KCV demonstrates the potential for intermittent use without anticoagulation.
• Hemodynamic and functional status improvements were documented in patients receiving KCV support.