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Evolutionary Improvements in the Jarvik 2000 Left Ventricular Assist Device.

Craig H Selzman1, Antigone Koliopoulou, Jason P Glotzbach

  • 1From the Division of Cardiothoracic Surgery, University of Utah, Salt Lake City, Utah.

ASAIO Journal (American Society for Artificial Internal Organs : 1992)
|January 12, 2018
PubMed
Summary

The Jarvik 2000 left ventricular assist device has been improved through real-world use, addressing rare failures and enhancing patient outcomes. Continuous case reviews drive design modifications for mechanical circulatory support systems.

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Area of Science:

  • Biomedical Engineering
  • Cardiovascular Devices
  • Medical Device Design

Background:

  • Mechanical circulatory support (MCS) devices operate under diverse patient conditions.
  • The Jarvik 2000 left ventricular assist device (LVAD) has undergone iterative design improvements since its initial implant in 2000.
  • Clinical application has identified low-incidence failure modes requiring device optimization.

Observation:

  • Real-world usage presents unique challenges not fully replicated in laboratory or animal testing.
  • Systematic case reviews of the Jarvik 2000 have been crucial for identifying areas of improvement.
  • Specific design modifications have addressed identified failure modes and enhanced device performance.

Findings:

  • Key modifications include a Y cable for uninterrupted battery changes, enhanced external cable strength (35 to 200 lbs), and an intermittent low-speed controller for improved aortic root washout.
  • Surface modifications, such as a sintered titanium microsphere pump housing, were implemented to prevent apical thrombus.
  • Novel cone bearings were introduced to mitigate thrombus formation, further enhancing device safety and efficacy.

Implications:

  • Continuous device refinement based on clinical experience is essential for improving MCS technology.
  • Real-world data collection and analysis are critical for advancing the safety and effectiveness of implanted medical devices.
  • The ongoing evolution of the Jarvik 2000 demonstrates the value of iterative design in long-term clinical support.