An advanced universal circulatory assist device for left and right ventricular support: First report of an acute in vivo implantCentral MessagePerspective

Background: The Advanced ventricular assist device (Advanced VAD) is designed as a universal pump intended to prevent backflow in the event of pump stoppage, to maintain physiological pulse pressure, and to be used as both a left and right VAD. The purpose of this study was to evaluate the performan...

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Main Authors: Takuma Miyamoto, MD, PhD, Yuichiro Kado, MD, PhD, David J. Horvath, MSME, Barry D. Kuban, BS, Shiva Sale, MD, Kiyotaka Fukamachi, MD, PhD, Jamshid H. Karimov, MD, PhD
Format: Article
Language:English
Published: Elsevier 2020-09-01
Series:JTCVS Open
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2666273620300553
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author Takuma Miyamoto, MD, PhD
Yuichiro Kado, MD, PhD
David J. Horvath, MSME
Barry D. Kuban, BS
Shiva Sale, MD
Kiyotaka Fukamachi, MD, PhD
Jamshid H. Karimov, MD, PhD
author_facet Takuma Miyamoto, MD, PhD
Yuichiro Kado, MD, PhD
David J. Horvath, MSME
Barry D. Kuban, BS
Shiva Sale, MD
Kiyotaka Fukamachi, MD, PhD
Jamshid H. Karimov, MD, PhD
author_sort Takuma Miyamoto, MD, PhD
collection DOAJ
description Background: The Advanced ventricular assist device (Advanced VAD) is designed as a universal pump intended to prevent backflow in the event of pump stoppage, to maintain physiological pulse pressure, and to be used as both a left and right VAD. The purpose of this study was to evaluate the performance of the Advanced VAD as both a left and right VAD in an acute in vivo study in calves. Methods: The Advanced VAD was implanted through a median sternotomy in 5 healthy calves (weight, 71.4-91.2 kg) as a left VAD (n = 3) or a right VAD (n = 2). After implantation, hemodynamic parameters, including general performance and pump stoppage, were evaluated. Results: The Advanced VAD was successfully implanted as a left and right VAD without cardiopulmonary bypass. The speed range of the Advanced VAD was 2500 to 3500 rpm as a left VAD and 2000 to 2500 rpm as a right VAD. Up to 4.3 L/min was achieved for both left and right VAD configurations. To demonstrate the automatic shut-off feature, the pump was stopped without clamping the outflow graft. The outflow graft was then clamped, which produced no significant changes in the arterial pressure waveform. The pulse pressures under the left VAD configuration were 38 mm Hg, 17 mm Hg, 14 mm Hg, and 16 mm Hg at baseline, 2500 rpm, 3000 rpm, and 3500 rpm, respectively. Conclusions: This acute in vivo study demonstrated the pump performance, anatomical fitting as both left VAD and right VAD, and regurgitant flow shut-off feature of the Advanced VAD.
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spelling doaj.art-89e1c55baa864f048bdcb8c1867dd06c2022-12-21T23:55:22ZengElsevierJTCVS Open2666-27362020-09-013140148An advanced universal circulatory assist device for left and right ventricular support: First report of an acute in vivo implantCentral MessagePerspectiveTakuma Miyamoto, MD, PhD0Yuichiro Kado, MD, PhD1David J. Horvath, MSME2Barry D. Kuban, BS3Shiva Sale, MD4Kiyotaka Fukamachi, MD, PhD5Jamshid H. Karimov, MD, PhD6Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OhioDepartment of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OhioR1 Engineering, Euclid, OhioDepartment of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio; Medical Device Solutions, Cleveland Clinic, Cleveland, OhioDepartment of Cardiothoracic Anesthesiology, Cleveland Clinic, Cleveland, OhioDepartment of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OhioDepartment of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio; Address for reprints: Jamshid H. Karimov, MD, PhD, Department of Biomedical Engineering, Cleveland Clinic, 9500 Euclid Ave/ND20, Cleveland, OH 44195.Background: The Advanced ventricular assist device (Advanced VAD) is designed as a universal pump intended to prevent backflow in the event of pump stoppage, to maintain physiological pulse pressure, and to be used as both a left and right VAD. The purpose of this study was to evaluate the performance of the Advanced VAD as both a left and right VAD in an acute in vivo study in calves. Methods: The Advanced VAD was implanted through a median sternotomy in 5 healthy calves (weight, 71.4-91.2 kg) as a left VAD (n = 3) or a right VAD (n = 2). After implantation, hemodynamic parameters, including general performance and pump stoppage, were evaluated. Results: The Advanced VAD was successfully implanted as a left and right VAD without cardiopulmonary bypass. The speed range of the Advanced VAD was 2500 to 3500 rpm as a left VAD and 2000 to 2500 rpm as a right VAD. Up to 4.3 L/min was achieved for both left and right VAD configurations. To demonstrate the automatic shut-off feature, the pump was stopped without clamping the outflow graft. The outflow graft was then clamped, which produced no significant changes in the arterial pressure waveform. The pulse pressures under the left VAD configuration were 38 mm Hg, 17 mm Hg, 14 mm Hg, and 16 mm Hg at baseline, 2500 rpm, 3000 rpm, and 3500 rpm, respectively. Conclusions: This acute in vivo study demonstrated the pump performance, anatomical fitting as both left VAD and right VAD, and regurgitant flow shut-off feature of the Advanced VAD.http://www.sciencedirect.com/science/article/pii/S2666273620300553animal studymechanical circulatory supportpulsatilityregurgitationventricular assist device
spellingShingle Takuma Miyamoto, MD, PhD
Yuichiro Kado, MD, PhD
David J. Horvath, MSME
Barry D. Kuban, BS
Shiva Sale, MD
Kiyotaka Fukamachi, MD, PhD
Jamshid H. Karimov, MD, PhD
An advanced universal circulatory assist device for left and right ventricular support: First report of an acute in vivo implantCentral MessagePerspective
JTCVS Open
animal study
mechanical circulatory support
pulsatility
regurgitation
ventricular assist device
title An advanced universal circulatory assist device for left and right ventricular support: First report of an acute in vivo implantCentral MessagePerspective
title_full An advanced universal circulatory assist device for left and right ventricular support: First report of an acute in vivo implantCentral MessagePerspective
title_fullStr An advanced universal circulatory assist device for left and right ventricular support: First report of an acute in vivo implantCentral MessagePerspective
title_full_unstemmed An advanced universal circulatory assist device for left and right ventricular support: First report of an acute in vivo implantCentral MessagePerspective
title_short An advanced universal circulatory assist device for left and right ventricular support: First report of an acute in vivo implantCentral MessagePerspective
title_sort advanced universal circulatory assist device for left and right ventricular support first report of an acute in vivo implantcentral messageperspective
topic animal study
mechanical circulatory support
pulsatility
regurgitation
ventricular assist device
url http://www.sciencedirect.com/science/article/pii/S2666273620300553
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