Devices
Mechanical Heart and Lung Support Devices
Mechanical heart and lung circulatory support is just one of a spectrum of treatment options offered for patients at the University of Maryland. We offer state-of-the-art care specifically tailored to the individual needs of end-stage heart and lung failure patients requiring mechanical circulatory support.
The Maryland Heart Center currently offers several bridge-to-transplant devices for heart support. Depending on the patient's medical condition and other circumstances, the patient, their family and the mechanical heart and lung support team work together to decide which device is the best option for each individual situation.
In addition, the University of Maryland Medical System is developing a lung support program using an extracorporeal membrane oxygenator ("ECMO") to provide artificial lung support for patients with life threatening lung disease. This approach is being explored as a bridge-to-transplant or for potentially reversible lung failure.
Bridge-to-transplant devices currently available at the Maryland Heart Center:
The Thoratec HeartMate II Left Ventricular Assist Device (LVAD) is a mechanical circulatory support device intended for a broad range of advanced-stage heart failure patients. HeartMate II is designed to restore blood flow, improve survival, functional status, and quality of life. the HeartMate II received FDA approval for Bridge-to-Transplantation (BTT) in April 2008. On January 20, 2010, FDA approval was received for Destination Therapy (DT), or long-term support, for those who do not qualify for heart transplantation due to age or other circumstances.
Measuring approximately 3 inches in length and weighing less than a pound, the HeartMate II is smaller and quieter than other FDA-approved LVADs. The HeartMate II is small enough to fit people of many sizes and ages, and it is designed to work for a number of years.
Advantages:
- Small pump pocket size, good for women and thinner, smaller-framed male patients who may not meet body surface area criteria for other devices.
- Very small electrical lead exiting the abdomen, more comfortable, reduced risk of site infection.
- Silent operation.
The CentriMag blood pump is an extracorporeal circulatory support device providing hemodynamic stabilization in patients in need of cardiopulmonary support. It used for patients who are expected to recover their heart function or who need a short-term bridge to a long-term device, who need short-term support, or who may need a temporary right-sided device after receiving an implanted LVAD.
Cleared for clinical use up to six hours, CentriMag can be used as a short-term solution to support the circulation while longer-term options are considered. CentriMag is approved for use as an RVAD for periods of support up to 30 days for patients in cardiogenic shock due to acute right ventricular failure.
Advantages:
- Simple to implant and manage.
- Can support the left or right ventricl alone, or both (with two pumps).
- External pump is easier to insert and remove.
- The CentriMag has a magnetically levitated pump impeller that provides a contact-free environment to reduce the risk of blood clotting and blood cell damage.
The Jarvik 2000 is the smallest and simplest left ventricular assist device (LVAD) available today. This a battery-powered flow pump is about the size of a thumb. The pump fits directly inside the heart's left chamber (ventricle) and continuously pushes oxygen-rich blood throughout the body, assisting the patient's own heart as a booster pump.
Compared to other heart assist devices, the Jarvik 2000 is much smaller, lighter and simpler. The Jarvik's size enables it to be used in small adults and children. It was designed to function reliably for as long as a decade. Although device recipients must take blood thinners, this device is expected to reduce the risk of blood clotting and infection. Those are problems sometimes associated with larger pulsatile pumps.
Right now the Jarvik 2000 is only FDA approved for experimental study as a bridge-to-transplant device. In the future, doctors hope that the pump will be safe and effective as a permanent assist device for a failing heart, and as a temporary implant to facilitate recovery of hearts treated with new medications or gene therapy approaches.
Thoratec VAD System
The Thoratec VAD System is able to provide left, right or biventricular support to patients of almost any size. It is the only VAD that is approved for use both as a bridge-to-transplant and for postcardiotomy recovery from open-heart surgery.
The Thoratec VAD System includes three major components: Blood pump, Cannulae, and Dual Drive Console or TLC-II® Portable Driver. This system provides partial or total circulatory assistance when the natural heart, with conventional therapy, is unable to maintain adequate circulation to perfuse vital organs. To accomplish support, blood flows from the natural heart to the VAD, which then pumps pulsatile blood flow back to the body.
The Thoratec VAD System is the only system that offers circulatory support for either the left side of the heart, the right side of the heart, or both sides of the heart. As of June 2001, the Thoratec VAD System has been used in more than 1,700 patients, and has been used in over 170 medical centers worldwide. It is FDA approved for bridge-to-cardiac transplantation and postcardiotomy recovery of the natural heart.
The Abiomed Impella 5.0 is a new type of investigational heart pump designed to give the heart a short-term rest after cardiac surgery. Cardiac surgeons at the University of Maryland Medical Center are the first in the region to implant this new type of investigational heart pump, as part of a seven-center, 20-patient pilot study.
The device has been approved for use in Europe, where more than 250 patients have been treated with it. The pencil-sized pump assists the left ventricle, the heart's main pumping chamber, for up to seven days. In some cases, it can be deployed without a large incision. The small pump, designed to fit inside a catheter, can be placed through an artery into the heart.
The Impella is the smallest device available for left ventricular pumping. It weighs only eight grams, but can do the work of much larger ventricular assist devices, pumping up to five liters of blood per minute, about three-quarters of a normal heart's output of seven liters per minute. The respite that the heart pump provides can be enough for the heart to bounce back to normal.
This page was last updated: June 19, 2013