Flashcards in VADs- Exam 2 Deck (109)
History: VAD 1930s - Carrell and Lindbergh and Demikhov
Experimented with mechanical support in animal models
History: 1953- Gibbon
1st use of CPB
Inability to wean fuelest interested in prolonged mechanical suport in order to promote myocardial recovery
History: 1963- Spencer, et. al
Reported using a roller pump to support a patient to recovery
Roller pumps aren't good VADS
What are the limitations of roller pumps as VADs?
Tethering, Blood trauma, Adjust pump speeds due to changes in heart pressures
History: 1966- DeBakey
1st successful clinical application of a true VAD
Pneumatically driven diaphragm pump
Describe the paracorporeal setup of DeBakey in 1966?
LA to Axillary ARtery
Describe DeBakey's patient and the use of the VAD
37 y/o patient who could not be weaned from CPB s/p AVR/ MVR
Supported for 10 days
Weaned and Discharged
History: 1960's Klaus, et al.
Introduced the concept of atrial counter pulsation
Rapid systolic unloading of the ventricle with diastolic augmentation
What did 1960's Klaus development lead to?
Development of the balloon pump which was developed in 1963 and applied clinically in 1967
When was the total artificial heart used in dog model? How long was it supported?
1962: TAH Reported survival for how long?
Up to 24 hours
1969: Cooley TAH
1st used a TAH to temporarily support a patient to transplant
47 y/o man failure to wean from CPB s/p LV Aneurysm repair
TAH had only been tested for up to 12 hours in animal model
Implanted the "Liotta Heart" which was a pneumatic device
Supported the patient for 64 hours
History: TAH: Research continued into the ________.
Who were the first investigators in the world to implant a permanent TAH on 12/2/1982.
University of Utah
Describe the first patient to receive a permanent TAH (University of Utah)
Jarvik 7 TAH performed by Dr. William DeVries
Implanted into Dr. Barney Clark, 61 y/o dentist with end stage idiopathic dilated cardiomyopathy
Died of complications from aspiration pneumonia, renal failure, colitis with septicemia
Was supported for 112 days
When 5 patients received permanent TAH under FDA trial, what was the longest survival?
1985: Where was the first planned TAH implant as a Bridge to Transplant?
Copeland at the University of Arizona
bridge to transplant
TAH: Device implanted in __________ had issues with the manufacturer so the FDA withdrew the FDA exemption for implantation. Describe the device.
Tuscon; Syncardia, Cardiowest
Who revived the Syncardia, Cardiowest model?
Drs. Olsen and Copeland (Tuscon, AZ)
Syncardia was modified and renamed what?
Cardiowest 70 received FDA approval as a BTT in _______.
____________ provided a stimulus for the development of VADs for support until transplant.
1978- Norman (VAD as a BTT)
Device used for 5 days of support
Intracorporeal pneumatic device
patient died of multi-organ system failure s/p transplant
Early 1980's- what happened with transplantation?
Transplanation became a widely applied therapy
What percent of patients died on the list in the early 1980's?
30%; became an incentive to develop devices that could be used for patients with acute cardiac decompensation while awaiting transplantation
1980: NIH sent out request for proposals to develop what?
"Implantable, integrated, electrically powered left heart assist system" that could be used on a long term basis and allow extensive patient mobility
9/1984 - Standford University: Oyer and Colleagues implanted what?
1st successful transplant s/p BTT with LVAD
Follow by Hill and colleagues who implanted a Pearce- Donachey pneumatic LVAD