Implantable left ventricular assist systems (LVASs) are used for bridging to transplantation,
bridging to myocardial improvement, and for permanent circulatory support. Conventional
implantable systems have inherent limitations that increase morbidity during support.
In contrast, small, efficient, axial-flow pumps, which have been under development
for the past decade, have the potential to improve the length and quality of life
in patients with severe heart failure. Methods and Results- To assess the safety and
clinical utility of the Jarvik 2000, we implanted this device in 10 transplant candidates
(mean age 51.3 years) in New York Heart Association (NYHA) class IV. Implantation
was achieved through a left thoracotomy during partial cardiopulmonary bypass. The
mean support period was 84 days. Within 48 hours postoperatively, the cardiac index
increased 43%, pulmonary capillary wedge pressure decreased 52%, systemic vascular
resistance decreased significantly, and inotropic support became unnecessary. Eight
patients underwent physical rehabilitation and returned to NYHA class I. Their left
ventricular dimensions, cardiothoracic ratios, and pressure-volume loop analyses showed
good left ventricular unloading. Seven patients underwent transplantation and 3 died
during support. No device thrombosis was observed at explantation.