L. Arusoglu

DuraHeart™ magnetically levitated centrifugal left ventricular assist system for advanced heart failure patients

The implantable left ventricular assist system (LVAS) using pulsatile pump technology has become an established therapeutic option for advanced heart failure patients. However, there have been technological limitations in some older designs, including a high incidence of infection and mechanical failures associated with moving parts, and the large size of both implantable pump and percutaneous cable. A smaller rotary blood pump emerged as a possible alternative to a large pulsatile pump to overcome some of these limitations. The technological advancement that defines the third-generation LVAS was the elimination of all mechanical contacts between the impeller and the drive mechanism. The DuraHeart™ LVAS is the world’s first third-generation implantable LVAS to obtain market approval (CE-mark), which combines a centrifugal pump and active magnetic levitation. The initial clinical experience with the DuraHeart LVAS in Europe demonstrated that it provided significantly improved survival (85% at 6 months and 79% at 1 year), reduced adverse event rates and long-term device reliability (freedom from device replacement at 2 years: 96 ± 3%) over pulsatile LVAS.

Total artificial heart-implantation technique using the CardioWest or the Thoratec system

Total artificial heart is a safe and efficient bridge for patients with terminal congestive heart failure awaiting cardiac transplantation. The implantation of the CardioWest total artificial heart has become an accepted therapeutic option in critically ill patients who have irreversible biventricular failure and are candidates for cardiac transplantation. Because of anatomical limitations in smaller patients (women, adolescents) implantation of the CardioWest system might be impossible. In these cases we have implanted the paracorporeal Thoratec device in a modified technique as a total artificial heart.

Thoratec Left Ventricular Assist Device Removal After Toxic Myocarditis

The clinical manifestation and natural history of myocarditis range is variable from asymptomatic stages to intractable circulatory compromise and death. Supportive therapy is paramount in the treatment of this condition. The use of mechanical circulatory support as bridge-to-recovery or bridge-to-transplantation in cases of cardiovascular collapse is often the only therapeutic option for these patients. We report the case of an adolescent boy with toxic myocarditis, due to cannabis abuse, who was supported with a Thoratec left ventricular assist device (Thoratec Laboratories Corp, Pleasanton, CA) for 96 days before device removal.