Skip Navigation



European Heart Journal Advance Access published online on March 30, 2005
European Heart Journal, doi:10.1093/eurheartj/ehi163
This Article
Right arrow Full Text (Rapid PDF)
Right arrow All Versions of this Article:
26/10/1031    most recent
ehi163v1
Right arrow E-letters: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Siegenthaler, M. P.
Right arrow Articles by Beyersdorf, F.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Siegenthaler, M. P.
Right arrow Articles by Beyersdorf, F.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

European Heart Journal © The European Society of Cardiology 2005; all rights reserved
Received August 9, 2004
Revised January 4, 2005
Accepted January 6, 2005

Clinical research

Advanced heart failure: feasibility study of long-term continuous axial flow pump support

Michael P. Siegenthaler 1*, Stephen Westaby 2, O.H. Frazier 3, Jürgen Martin 1, Adrian Banning 2, Desiree Robson 2, John Pepper 4, Phillip Poole-Wilson 4, and Friedhelm Beyersdorf 1

1 Center for Cardiovascular Disease, University of Freiburg Medical Center, Hugstetterstrasse 55, 79106 Freiburg, Germany
2 John Radcliffe Hospital, Oxford, UK
3 Department of Cardiovascular Surgery, Texas Heart Institute, Houston, TX, USA
4 Royal Brompton and Harefield Hospital Trust and Imperial College, London, UK

* To whom correspondence should be addressed.
Michael P. Siegenthaler, E-mail: siegenth{at}ch11.ukl.uni-freiburg.de


  Abstract

Aims A lack of donor hearts has stimulated interest in using blood pumps to treat severe heart failure. We tested the hypothesis that a new continuous flow circulatory assist device could be employed safely to relieve symptoms of heart failure and evaluated the potential to prolong life.

Methods and results An intracardiac axial flow pump was implanted in 17 heart failure patients [idiopathic dilated (12), ischaemic (4), or amyloid cardiomyopathy (1)]. All were deemed ineligible for transplantation. Implantation of the device was by left thoracotomy (15) or median sternotomy (2). Power delivery was by a skull-mounted titanium pedestal. All patients survived surgery. None needed right ventricular support. There were three hospital deaths, two early from subdural haematoma and aortic thrombosis, one late after switching to transplantation. A total of 14 patients left hospital with a cumulative support-time of 15.9 years (median: 293 days, interquartile range: 286 days, 1-44 months). Actuarial 1-, 2-, and 3-year survivals were 56, 47, and 24%, respectively. There was no pump failure. Quality of life scores improved. Two superficial pedestal infections were successfully treated. Four patients had cerebral thrombo-embolism: two early events attributed to inadequate anticoagulation and two late with near-complete resolution. An improved anticoagulant regime addressed this problem. Late death occurred in five patients from battery disconnection, subdural haematoma, bowel ischaemia, respiratory failure, and after cardiac transplantation.

Conclusion Continuous flow blood pumps provided symptomatic relief of severe heart failure with high quality of life. Event-free survival reached 4 years. Analysis of adverse events led to improved management strategies. There is potential for widespread use of blood pumps in the community. A controlled trial is required.

Keywords: Heart failure; Circulatory support; Lifetime use; Destination therapy; Jarvik 2000; Complications.
Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 J. Thorac. Cardiovasc. Surg.Home page
C. Loffler, A. Straub, N. Bassler, K. Pernice, F. Beyersdorf, C. Bode, M. P. Siegenthaler, and K. Peter
Evaluation of platelet activation in patients supported by the Jarvik 2000* high-rotational speed impeller ventricular assist device.
J. Thorac. Cardiovasc. Surg., March 1, 2009; 137(3): 736 - 741.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
U. Geisen, C. Heilmann, F. Beyersdorf, C. Benk, M. Berchtold-Herz, C. Schlensak, U. Budde, and B. Zieger
Non-surgical bleeding in patients with ventricular assist devices could be explained by acquired von Willebrand disease
Eur. J. Cardiothorac. Surg., April 1, 2008; 33(4): 679 - 684.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
M. Markl, C. Benk, D. Klausmann, A. F. Stalder, A. Frydrychowicz, J. Hennig, and F. Beyersdorf
Three-dimensional magnetic resonance flow analysis in a ventricular assist device.
J. Thorac. Cardiovasc. Surg., December 1, 2007; 134(6): 1471 - 1476.
[Abstract] [Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
J. B. Selvanayagam, P. N. Hawkins, B. Paul, S. G. Myerson, and S. Neubauer
Evaluation and Management of the Cardiac Amyloidosis
J. Am. Coll. Cardiol., November 27, 2007; 50(22): 2101 - 2110.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
M. P. Siegenthaler, O.H. Frazier, F. Beyersdorf, J. Martin, H. Laks, J. Elefteriades, A. Khaghani, U. Kjellman, B. Koul, J. Pepper, et al.
Mechanical reliability of the jarvik 2000 heart.
Ann. Thorac. Surg., May 1, 2006; 81(5): 1752 - 1759.
[Abstract] [Full Text] [PDF]

Home page
 Eur Heart JHome page
M. C. Deng
The challenges of generating evidence to guide mechanical circulatory support-based management of advanced heart failure
Eur. Heart J., May 2, 2005; 26(10): 953 - 955.
[Full Text] [PDF]


Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.