Design concepts and principle of operation of the HeartWare ventricular assist system

Implantable left ventricular assist devices provide circulatory support for patients at risk of death from refractory, end-stage heart failure. Rotary blood pumps have been designed for increased reliability and smaller size for use in a broader population of patients than the first-generation pulsatile devices. The design concepts and principle of operation of the HeartWare System are discussed. The HeartWare Ventricular Assist System (HVAD) is a small centrifugal flow pump with a displacement volume of 50 ml and an output capacity of 10 L/min. A unique wide-blade impeller is suspended by hybrid passive magnets and hydrodynamic forces. An integrated inflow cannula is inserted into the left ventricle and is held in position by an adjustable sewing ring; the pump is positioned in the pericardial space. The 10-mm outflow graft is anastomosed to the ascending aorta. External system components include the microprocessor-based controller, a monitor, lithium-ion battery packs, alternating current and direct current power adapters, and a battery charger. Physiologic control algorithms are incorporated for safe operation. Preclinical life cycle tests have shown the HVAD to be highly reliable. This system design offers reliability, portability, and ease of use for ambulatory patients.