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Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
Published on: June 12, 2021
Off-pump insertion of continuous flow left ventricular assist devices
Craig H Selzman1, Brett C Sheridan
1Division of Cardiothoracic Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599-7065, USA. selzman@med.unc.edu
Journal of Cardiac Surgery
|July 31, 2007
Summary
Implanting a left ventricular assist device (LVAD) without cardiopulmonary bypass (CPB) is feasible and safe. This off-CPB approach for LVAD insertion shows potential advantages, reducing complications and recovery time for heart failure patients.
Area of Science:
- Cardiovascular Surgery
- Medical Devices
- Heart Failure Management
Background:
- Traditional left ventricular assist device (LVAD) implantation often necessitates cardiopulmonary bypass (CPB).
- Cardiopulmonary bypass carries risks such as right ventricular dysfunction, end-organ injury, and bleeding, particularly in critically ill heart failure patients.
Purpose of the Study:
- To assess the feasibility and outcomes of left ventricular assist device (LVAD) implantation performed without cardiopulmonary bypass (CPB).
Main Methods:
- A phase I clinical trial utilized the Jarvik 2000 axial-flow pump in seven status I end-stage heart failure patients.
- LVAD insertion was performed via thoracotomy or sternotomy, with or without CPB support.
Main Results:
- Five of seven patients received the Jarvik 2000 LVAD off-CPB.
- Off-CPB implantation was associated with shorter surgery, reduced mechanical ventilation, fewer blood transfusions, less inotropic support, and shorter hospital stays.
- Most patients experienced complete resolution of liver and kidney dysfunction.
Conclusions:
- Off-pump insertion of axial flow LVADs is demonstrated as a feasible, safe, and potentially advantageous strategy.
- While perioperative simplicity is encouraging, further studies are needed to compare outcomes with traditional methods for widespread adoption.
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