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Performance of the Jarvik 2000 left ventricular assist device on mid-term hemodynamics and exercise capacity

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  • Artificial Heart (Clinical)
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Abstract

The hemodynamic and exercise capacity performance of the Jarvik 2000 left ventricular assist device (LVAD), which is generally used in patients with small body size and relatively preserved cardiac function, is not well understood. We retrospectively examined 18 patients implanted with the Jarvik 2000 LVAD. Pump rotation speed was optimized by the hemodynamic ramp test one year after implantation based on the criteria of mean pulmonary capillary wedge pressure (PCWP) < 18 mmHg, mean right atrial pressure (RAP) < 12 mmHg, and cardiac index (CI) > 2.2 L/min/m2 as well as echocardiographic parameters. Exercise capacity was assessed by cardiopulmonary exercise test in an optimized setting. To investigate the impacts of larger body surface area (BSA) and extremely impaired pre-implantation cardiac function on hemodynamics and exercise capacity, two correlation analyses based on BSA and original CI were performed. At a pump speed of 9500 ± 707 rpm, the mean pulmonary artery pressure, PCWP, RAP, and CI were 17 ± 5 mmHg, 9 ± 5 mmHg, 6 ± 4 mmHg, and 2.82 ± 0.54 L/min/m2, respectively. Only one patient failed to achieve the hemodynamic criteria. The peak VO2 and VE/VCO2 slope were 12.9 ± 3.1 mL/min/kg and 37.7 ± 15.0, respectively. There was an inverse correlation between original CI and heart rate (r = −0.60, p  =  0.01), and a weak correlation between BSA and PCWP (r  =  0.43, p  =  0.08). Based on this study, the overall performance of the Jarvik 2000 device was acceptable, and the patients’ body size and original cardiac function had minimum effect on the performance of this device.

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Acknowledgements

We would like to thank Toshimitsu Koike and Yuhei Otsuka for technical assistance for CPET, and Editage (www.editage.jp) for English language editing. This work was supported by JSPS KAKENHI (grant number 19K17514).

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Authors and Affiliations

  1. Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan

    Togo Iwahana, Sho Okada, Hirotoshi Kato, Ryohei Ono & Yoshio Kobayashi

  2. Department of Cardiovascular Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan

    Hiroki Kohno & Goro Matsumiya

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  1. Togo Iwahana
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  2. Hiroki Kohno
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Correspondence to Togo Iwahana or Hiroki Kohno.

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Two authors (HK and GM) received research grant from Century Medical, Inc. All the other authors have no conflicts of interest to declare.

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Iwahana, T., Kohno, H., Okada, S. et al. Performance of the Jarvik 2000 left ventricular assist device on mid-term hemodynamics and exercise capacity. J Artif Organs 25, 204–213 (2022). https://doi.org/10.1007/s10047-021-01302-3

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