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Left ventricular assist devices: yesterday, today, and tomorrow

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  • Artificial Heart (Clinical)
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Abstract

The shortcomings of expense, power requirements, infection, durability, size, and blood trauma of current durable LVADs have been recognized for many years. The LVADs of tomorrow aspire to be fully implantable, durable, mitigate infectious risk, mimic the pulsatile nature of the native cardiac cycle, as well as minimize bleeding and thrombosis. Power draw, battery cycle lifespan and trans-cutaneous energy transmission remain barriers to completely implantable systems. Potential solutions include decreases in pump electrical draw, improving battery lifecycle technology and better trans-cutaneous energy transmission, potentially from Free-range Resonant Electrical Energy Delivery. In this review, we briefly discuss the history of LVADs and summarize the LVAD devices in the development pipeline seeking to address these issues.

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References

  1. Virani SS, Alonso A, Benjamin EJ, Bittencourt MS, Callaway CW, Carson AP, et al. Heart disease and stroke statistics—2020 update: a report from the American Heart Association. Circulation. 2020;141:e139-596.

    Article  PubMed  Google Scholar 

  2. Benjamin EJ, Muntner P, Alonso A, Bittencourt MS, Callaway CW, Carson AP, et al. Heart disease and stroke statistics—2019 update: a report from the American Heart Association. Circulation. 2019;139:e56-528.

    Article  PubMed  Google Scholar 

  3. DeBakey ME. Left ventricular bypass pump for cardiac assistance. Clinical experience Am J Cardiol. 1971;27:3–11.

    CAS  PubMed  Google Scholar 

  4. Higgins R, Tang D. Long-Term Mechanical Circulatory Support and TAH. In: Baumgartner WA, Jacobs JP, Darling GE, eds. Adult and Pediatric Cardiac Surgery. STS Cardiothoracic Surgery E-Book. Chicago: Society of Thoracic Surgeons; 2021. ebook.sts.org. Accessed April 30, 2023

  5. Mehta SM, Pae WE Jr, Rosenberg G, Snyder AJ, Weiss WJ, Lewis JP, Frank DJ, Thompson JJ, Pierce WS. The LionHeart LVD-2000: a completely implanted left ventricular assist device for chronic circulatory support. Ann Thorac Surg. 2001;71:156–61.

    Article  Google Scholar 

  6. Rose EA, Gelijns AC, Moskowitz AJ, Heitjan DF, Stevenson LW, Dembitsky W, et al. Long-term use of a left ventricular assist device for end-stage heart failure. Randomized Evaluation of Mechanical Assistance for the Treatment of Congestive Heart Failure (REMATCH) Study Group. N Engl J Med. 2001;345:1435–43.

    Article  CAS  PubMed  Google Scholar 

  7. Morgan JA, Stewart AS, Lee BJ, Oz MC, Naka Y. Role of the Abiomed BVS 5000 device for short-term support and bridge to transplantation. ASAIO J. 2004;50:360–3.

    Article  PubMed  Google Scholar 

  8. Saito S, Matsumiya G, Sakaguchi T, Fujita T, Kuratani T, Ichikawa H, Sawa Y. Fifteen-year experience with Toyobo paracorporeal left ventricular assist system. J Artif Organs. 2009;12:27–34.

    Article  PubMed  Google Scholar 

  9. Starling RC, Moazami N, Silvestry SC, Ewald G, Rogers JG, Milano CA, Rame JE, Acker MA, Blackstone EH, Ehrlinger J, Thuita L, Mountis MM, Soltesz EG, Lytle BW, Smedira NG. Unexpected abrupt increase in left ventricular assist device thrombosis. N Engl J Med. 2014;370:33–40.

    Article  CAS  PubMed  Google Scholar 

  10. Slaughter MS, Pagani FD, Rogers JG, Miller LW, Sun B, Russell SD, Starling RC, Chen L, Boyle AJ, Chillcott S, Adamson RM, Blood MS, Camacho MT, Idrissi KA, Petty M, Sobieski M, Wright S, Myers TJ, Farrar DJ. HeartMate II Clinical Investigators. Clinical management of continuous-flow left ventricular assist devices in advanced heart failure. J Heart Lung Transplant. 2010;29:1–39.

    Article  Google Scholar 

  11. Slaughter MS, Rogers JG, Milano CA, Russell SD, Conte JV, Feldman D, Sun B, Tatooles AJ, Delgado RM 3rd, Long JW, Wozniak TC, Ghumman W, Farrar DJ, Frazier OH. HeartMate II Investigators. Advanced heart failure treated with continuous-flow left ventricular assist device. N Engl J Med. 2009;361:2241–51.

    Article  CAS  PubMed  Google Scholar 

  12. Bourque K, Cotter C, Dague C, Harjes D, Dur O, Duhamel J, Spink K, Walsh K, Burke E. Design Rationale and Preclinical Evaluation of the HeartMate 3 Left Ventricular Assist System for Hemocompatibility. ASAIO J. 2016;62:375–83.

    Article  CAS  PubMed  Google Scholar 

  13. Mehra MR, Naka Y, Uriel N, Cleveland JC Jr, Yuzefpolskaya M, Salerno CT, et al. A Fully Magnetically Levitated Circulatory Pump for Advanced Heart Failure. N Engl J Med. 2017;376:440–50.

    Article  PubMed  Google Scholar 

  14. Mehra MR, Goldstein DJ, Cleveland JC, Cowger JA, Hall S, Salerno CT, Naka Y, Horstmanshof D, Chuang J, Wang A, Uriel N. Five-Year Outcomes in Patients With Fully Magnetically Levitated vs Axial-Flow Left Ventricular Assist Devices in the MOMENTUM 3 Randomized Trial. JAMA. 2022;328:1233–42.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Miller LW, Pagani FD, Russell SD, Miller LW, Pagani FD, Russell SD, John R, Boyle AJ, Aaronson KD, Conte JV, Naka Y, Mancini D, Delgado RM, MacGillivray TE, Farrar DJ, Frazier OH. HeartMate II Clinical Investigators. Use of a continuous-flow device in patients awaiting heart transplantation. N Engl J Med. 2007;357:885–96.

    Article  CAS  PubMed  Google Scholar 

  16. Chatterjee A, Feldmann C, Dogan G, Hanke JS, Ricklefs M, Deniz E, Haverich A, Schmitto JD. Clinical overview of the HVAD: a centrifugal continuous-flow ventricular assist device with magnetic and hydrodynamic bearings including lateral implantation strategies. J Thorac Dis. 2018;10:S1785–9.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Wieselthaler GMO, Driscoll G, Jansz P, et al. HVAD Clinical Investigators Initial clinical experience with a novel left ventricular assist device with a magnetically levitated rotor in a multi-institutional trial. J Heart Lung Transplant. 2010;29:1218–25.

    Article  PubMed  Google Scholar 

  18. Strueber M, Larbalestier R, Jansz P, et al. Results of the post-market Registry to Evaluate the HeartWare Left Ventricular Assist System (ReVOLVE). J Heart Lung Transplant. 2014;33:486–91.

    Article  PubMed  Google Scholar 

  19. Aaronson KD, Slaughter MS, Miller LW, et al. Use of an intrapericardial, continuous-flow, centrifugal pump in patients awaiting heart transplantation. Circulation. 2012;125:3191–200.

    Article  PubMed  Google Scholar 

  20. Slaughter MS, Pagani FD, McGee EC, et al. HeartWare ventricular assist system for bridge to transplant: combined results of the bridge to transplant and continued access protocol trial. J Heart Lung Transplant. 2013;32:675–83.

    Article  PubMed  Google Scholar 

  21. https://www.fda.gov/medical-devices/medical-device-recalls/medtronic-stops-distribution-and-sale-heartware-hvad-system-due-risk-neurological-adverse-events. Last accessed December 2023

  22. Morshuis M, El-Banayosy A, Arusoglu L, Koerfer R, Hetzer R, Wieselthaler G, Pavie A, Nojiri C. European experience of DuraHeart magnetically levitated centrifugal left ventricular assist system. Eur J Cardiothorac Surg. 2009;35:1020–7.

    Article  PubMed  Google Scholar 

  23. Moazami N, Steffen RJ, Naka Y, Jorde U, Bailey S, Murali S, Camacho MT, Zucker M, Marascalco PJ, Rao V, Feldman D. SUSTAIN Investigators Lessons learned from the first fully magnetically levitated centrifugal LVAD trial in the United States: the DuraHeart trial. Ann Thorac Surg. 2014;98:541–7.

    Article  PubMed  Google Scholar 

  24. Pozzi M, Giraud R, Tozzi P, Bendjelid K, Robin J, Meyer P, Obadia JF, Banfi C. Long-term continuous-flow left ventricular assist devices (LVAD) as bridge to heart transplantation. J Thorac Dis. 2015;7:532–42.

    PubMed  PubMed Central  Google Scholar 

  25. Selzman CH, Feller ED, Walker JC, Sheridan BC, Silvestry SC, Daly RC, Anyanwu AC, Madigan D, Liu P, Frazier OH, Jorde UP, Griffith PB. he Jarvik 2000 Left Ventricular Assist Device: Results of the United States Bridge to Transplant Trial. ASAIO J. 2023;69:174–82.

    Article  PubMed  Google Scholar 

  26. Paya Y, Maly J, Bekbossynova M, Salov R, Schueler S, Meyns B, Kassif Y, Massetti M, Zilbershlag M, Netuka I. First human use of wireless coplanar energy transfer coupled with a continuous flow left ventricular assist device. J Heart Lung Transplant. 2019;38:339–43.

    Article  Google Scholar 

  27. Westaby S. Evolution of a circulatory support system with full implantability: personal perspectives on a long journey. Br J Cardiol. 2022;29:21.

    PubMed  PubMed Central  Google Scholar 

  28. Slaughter MS. LVADs of Tomorrow: What are the Unmet Needs? Louisville, KY: University of Louisville; 2022.

    Google Scholar 

  29. Meyer AL, Malehsa D, Budde U, Bara C, Haverich A, Strueber M. Acquired von Willebrand syndrome in patients with a centrifugal or axial continuous flow left ventricular assist device. JACC Heart Fail. 2014;2:141–5 ([PMID:24720921]).

    Article  PubMed  Google Scholar 

  30. Stein A, Kovacevic M, Phyo AK, Anderson R, Verma R, Provos J, Brandmire A, Iudice J. CARD14: Wireless Transcutaneous Energy Transfer and Control System for Powering a Fully-Implanted Left-Ventricular Assist System. ASAIO J. 2023;69:1.

    Article  Google Scholar 

  31. Wu Y, Zhu LF, Luo Y. Development and current clinical application of ventricular assist devices in China. J Zhejiang Univ Sci B. 2017;18:934–45.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Zhang J, Chen Z, Griffith B, Wu ZJ. Computational characterization of flow and blood damage potential of the new maglev CH-VAD pump versus the HVAD and HeartMate II pumps. Int J Artif Organs. 2020;43:653–62.

    Article  CAS  PubMed  Google Scholar 

  33. Kawamura A, Toda K, Sawa Y. First clinical experience with the double cuff tipless inflow cannula in the EVAHEART left ventricular assist system: Case report. Artif Organs. 2020;44:436–7.

    Article  PubMed  Google Scholar 

  34. Allen SR, Slaughter MS, Ahmed MM, Bartoli CR, Dhingra R, Egnaczyk GF, Gulati SK, Kiernan MS, Mahr C, Meyer DM, Motomura T, Ono M, Ravichandran A, Shafii A, Smith J, Soleimani B, Toyoda Y, Yarboro LT, Dowling RD. COMPETENCE Trial: The EVAHEART 2 continuous flow left ventricular assist device. J Heart Lung Transplant. 2023;42:33–9.

    Article  PubMed  Google Scholar 

  35. CorWave. https://www.corwave.com/product/corwave-lvad. Last accessed December 2023

  36. Corvion, Inc. Our Technology: Cutting the Cord. Corvion, Inc. Updated 2022. Accessed December, 2023. https://corvion.com/technology-corvion/

  37. Fang P, Yang Y, Wei X, Yu S. Preclinical evaluation of the fluid dynamics and hemocompatibility of the Corheart 6 left ventricular assist device. Artif Organs. 2023;47:951–60.

    Article  CAS  PubMed  Google Scholar 

  38. European Cardiovascular Research Center. www.cerc-europe.org/lvad-corheart6. Last accessed December 2023

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Authors and Affiliations

  1. Department of Surgery, Division of Cardiac Surgery, University of Mississippi Medical Center, 2500 N State St, Jackson, MS, 39216, USA

    Athanasios Tsiouris, Ashok Kumar Coimbatore Jeyakumar & Adam N. Protos

  2. Department of Cardiovascular and Thoracic Surgery, University of Louisville, 201 Abraham Flexner Way, Louisville, KY, 40202, USA

    Mark S. Slaughter

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  1. Athanasios Tsiouris
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Contributions

AT: drafting article, critical revision of article, approval of article. MS: concept/design, critical revision of article, approval of article. AKCJ: critical revision of article, approval of article. AP: concept design, critical revision of article, approval of article.

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Correspondence to Athanasios Tsiouris.

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Tsiouris, A., Slaughter, M.S., Jeyakumar, A.K.C. et al. Left ventricular assist devices: yesterday, today, and tomorrow. J Artif Organs (2024). https://doi.org/10.1007/s10047-024-01436-0

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