From the Oxford Heart Centre (S.W., T.K., R.H., R.E., D.P.), Oxford, UK;
the Texas Heart Institute (O.H.F.), Houston, Tex, and Jarvik Heart, Inc
(R.J.), New York, NY.
Correspondence to Stephen Westaby, MS, FRCS, Oxford Heart Centre, John Radcliffe Hospital, Headley Way, Headington, Oxford OX3 9DU, UK.
Background—Mechanical bridge to
left ventricular recovery is an emerging strategy for the
treatment of heart failure. We sought to validate the use of a new
intracardiac axial flow impeller pump for this purpose.
Methods and Results—The Jarvik 2000 Heart was implanted into 30
sheep to ascertain mechanical reliability, biocompatibility, and
hemodynamic function. We attempted but failed to
anticoagulate with warfarin. Elective explants with survival were
performed in 3 animals to simulate bridge to recovery. Extensive
autopsy studies were performed in all other animals. At speeds between
8000 and 12 000 rpm the device pumped up to 8 L/min, captured all
mitral flow, and augmented cardiac output with elevation of mean
arterial pressure. The pump was silent and hemolysis
negligible. Nonpulsatile flow did not adversely affect neurological or
renal function. Device removal proved straightforward and safe. A
fractured inflow bearing occurred in 1 early model. There were no other
pump failures, but power interruption occurred when the sheep chewed
the cables or head-butted the percutaneous
pedestal. At autopsy, there was no thromboembolism or primary
thrombus formation in any device. Pump occlusion occurred in 2 sheep
with bacterial endocarditis. One electively explanted pump, previously
switched off for 5 months, had no thrombus in the device or vascular
graft.
Conclusions—The Jarvik 2000 Heart is a major advance in
blood-pump technology and increases the scope of mechanical circulatory
support. Reliability and ease of removal favor its use for bridge to
myocyte recovery, as well as for bridge to transplantation or long-term
support.
© 1998 American Heart Association, Inc.
Basic Science Reports
Jarvik 2000 Heart
Potential for Bridge to Myocyte Recovery
Key Words: heart failure • myocytes • Jarvik 2000 • heart-assist device
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