Examples of the many options for mechanical circulatory assistance available at the Center for Circulatory Support at the University of Michigan include:
- HeartMate® XVE Left Ventricular Assist System
- HeartMate II Left Ventricular Assist System
- Terumo DuraHeart Left Ventricular Assist System
- Thoratec IVAD Ventricular Assist Device
- DeBakey Left Ventricular Assist Device
- Novacor® Left Ventricular Assist Device
- Syncardia Total Artificial Heart
- Berlin Heart Ventricular Assist Device
- TandemHeart™ pVAD Ventricular Assist Device
- Abiomed BVS5000™ Ventricular Assist Device
- Abiomed AB5000™ Ventricular Assist Device
- Extra Corporeal Life Support
The Thoratec HeartMate® XVE LVAS (vented electric) was developed and tested by Thermo Cardiosystems, Inc. This titanium blood pump consists of a blood chamber, motor chamber, drive-line, and inflow and outflow conduits. The pump weighs 1150 grams. Each conduit contains a 25-mm porcine (pig) valve within a woven Dacron?-fabric graft. A polyurethane diaphragm separates the blood chamber and the motor chamber. Textured surfaces within the blood chamber promote the development of a cellular lining, which helps prevent blood clots and infection. The XVE LVAS has a maximum stroke volume of 83 milliliters. It can be operated at up to 120 beats per minute, resulting in flow rates of up to 10 liters per minute.
The HeartMate II is a high-speed, axial flow, rotary blood pump. As an axial flow device, the HeartMate II produces no pulsatile action. Weighing 12 ounces (about 375 grams) and measuring about 1.5 inches (4 cm) in diameter and 2.5 inches (6 cm) long, it is significantly smaller than other currently approved devices. As such, it may be suitable for a wider range of patients, including small adults and children. Approved by the U.S. Food and Drug Administration for national use in April 2008, after a clinical trial that was co-led by U-M, the HeartMate II is now available as a bridge to transplant and is being evaluated as a long-term destination therapy.
In July, 2008, the first operation outside Europe to implant the DuraHeart device in a patient was performed at the U-M Cardiovascular Center. This device, which uses magnetic levitation (maglev) technology and a centrifugal flow rotary pump to push blood from the heart and to the body, is considered a third-generation VAD. Designed for long-term patient support, this experimental device is now being made available through a clinical trial at U-M and other American centers; it is already approved for use in Europe. U-M co-leads the national trial and is the training center for teams from around the country that are participating in the trial. For more information on the trial, visit this page.
The Thoratec IVAD is now FDA approved for use in bridge-to-transplantation and post-cardiotomy recovery patients who are unable to be weaned from cardiopulmonary bypass. The IVAD is the only currently approved, implantable cardiac assist device that can provide left, right or biventricular support. It was recently approved for use in Europe. The IVAD's compact size facilitates implants to assist both ventricles and enables it to accommodate a wide range of patients, including those who were previously unable to receive an implantable, pulsatile device.
The MicroMed DeBakey VAD® is a miniaturized heart pump designed to provide increased blood flow (up to 10L/min) from the left ventricle of the heart throughout the body for patients in end-stage heart failure. About 1/10 the size of competitive pulsatile VAD products on the market and weighing less than four ounces, the MicroMed DeBakey VAD? measures 1" x 3". This smaller size allows it to be used in patients with smaller body types, such as petite women and children in whom larger devices could not be implanted. The small size of the device and flexible percutaneous cable also reduces infection rates. The University of Michigan is participating in the clinical trial of this device and was one of the first centers to implant the pediatric version of the pump.
WorldHeart's Novacor® LVAS is an implanted, wearable system that provides pulsatile circulatory support for patients with life-threatening heart failure. Novacor? LVAS has been implanted in more than 1,700 patients, and is the first mechanical circulatory support device to support a single patient for more than six years.
This medical device is the modern version of the Jarvik 7 artificial heart first implanted into Barney Clark in 1982. The CardioWest temporary Total Artificial Heart is the only FDA approved temporary total artificial heart in the world. The TAH t is used as a bridge to heart transplant for eligible patients suffering from end-stage biventricular failure.
The Berlin Heart is a ventricular assist device which can be configured to support any size pediatric patient from newborn to full-grown teenager. The Berlin Heart has been used extensively in Europe as a bridge to transplant, and in some cases, a bridge to recovery. Although it is not currently FDA approved, special permission can be obtained for implantation in the United States. At the University of Michigan's C.S. Mott Children's Hospital, many children have undergone ventricular assist device implantation using a variety of devices, including the Berlin Heart.
The TandemHeart™ Percutaneous Ventricular Assist Device (pVAD) differs from other assist devices in that it can be inserted either by cardiovascular surgeons in the operating room or by cardiologists in the cardiac catheterization laboratory. The TandemHeart has been used in postcardiotomy cardiogenic shock patients (those who have developed heart failure as a result of heart surgery or a heart attack) and as a bridge to a more definitive therapy. The TandemHeart pVAD provides short-term support from a few hours up to 14 days, giving the heart time to recover and regain native function.
The ABIOMED BVS 5000™ is used worldwide for temporary left, right, or biventricular (both ventricles) support in patients with potentially reversible heart failure. It was the first heart assist device approved by the US Food and Drug Administration for the support of post-cardiotomy patients (those who have developed heart failure as a result of heart surgery). Since that time, hundreds of patients have been sustained by the BVS 5000.
The ABIOMED AB5000™ Circulatory Support System is a short-term mechanical system that can provide left, right, or biventricular support for patients whose hearts have failed but have the potential for recovery. The AB5000 can be used to support the heart, giving it time to rest – and potentially recover native heart function. The device can also be used as a bridge to definitive therapy. The AB5000, recently approved by the US Food and Drug Administration (FDA), builds upon more than 20 years of research and development for similar technologies, including the ABIOMED BVS 5000.
Some patients may develop lung failure in addition to heart failure. Supplemental oxygen or even artificial respirators are often incapable of providing life sustaining oxygen or removing dangerous carbon dioxide when the lungs are severely affected. Another form of life support can stabilize these patients while the organs recover. This treatment is termed ECMO, or Extra Corporeal Life Support, and involves insertion of catheters into the large blood vessels of the neck or groin. Using pumps, blood is circulated through membranes capable of transferring oxygen and carbon dioxide, similar to our native lungs. This blood is then circulated back into the body. Patients can be supported for days to weeks, until the heart and lungs recover, or until an implantable replacement or transplant becomes available. The University of Michigan has the largest ECMO experience in the world, and frequently hosts visitors from around the globe for education and training. Our team is capable of instituting ECMO within minutes or, under special circumstances, traveling to referring institutions to initiate ECMO for a safer transport to our center.