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Flashcards in VADs- Exam 2 Deck (109)
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1

History: VAD 1930s - Carrell and Lindbergh and Demikhov

Experimented with mechanical support in animal models

2

History: 1953- Gibbon

1st use of CPB
Inability to wean fuelest interested in prolonged mechanical suport in order to promote myocardial recovery

3

History: 1963- Spencer, et. al

Reported using a roller pump to support a patient to recovery
Roller pumps aren't good VADS

4

What are the limitations of roller pumps as VADs?

Tethering, Blood trauma, Adjust pump speeds due to changes in heart pressures

5

History: 1966- DeBakey

1st successful clinical application of a true VAD
Pneumatically driven diaphragm pump
Paracorporeal

6

Describe the paracorporeal setup of DeBakey in 1966?

LA to Axillary ARtery

7

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

8

History: 1960's Klaus, et al.

Introduced the concept of atrial counter pulsation
Rapid systolic unloading of the ventricle with diastolic augmentation

9

What did 1960's Klaus development lead to?

Development of the balloon pump which was developed in 1963 and applied clinically in 1967

10

When was the total artificial heart used in dog model? How long was it supported?

1958
90 minutes

11

1962: TAH Reported survival for how long?

Up to 24 hours

12

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

13

History: TAH: Research continued into the ________.

1980's

14

Who were the first investigators in the world to implant a permanent TAH on 12/2/1982.

University of Utah

15

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

16

When 5 patients received permanent TAH under FDA trial, what was the longest survival?

620 days

17

1985: Where was the first planned TAH implant as a Bridge to Transplant?

Copeland at the University of Arizona

18

BTT

bridge to transplant

19

TAH: Device implanted in __________ had issues with the manufacturer so the FDA withdrew the FDA exemption for implantation. Describe the device.

Tuscon; Syncardia, Cardiowest

20

Who revived the Syncardia, Cardiowest model?

Drs. Olsen and Copeland (Tuscon, AZ)

21

Syncardia was modified and renamed what?

Cardiowest C70

22

Cardiowest 70 received FDA approval as a BTT in _______.

2004

23

____________ provided a stimulus for the development of VADs for support until transplant.

Transplantation

24

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

25

Early 1980's- what happened with transplantation?

Transplanation became a widely applied therapy

26

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

27

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

28

9/1984 - Standford University: Oyer and Colleagues implanted what?

Novacor LVAD

29

Novacor LVAD

1st successful transplant s/p BTT with LVAD
Follow by Hill and colleagues who implanted a Pearce- Donachey pneumatic LVAD

30

1992- Frazier and colleagues

1st to report successful BTT with Thoratec Heartmate IP VAD
(implantable, pneumatic)
restored near normal hemodynamics