Biomedical engineering management of Novacor left Ventricular assist system (LVAS) patients

Abstract

As the number of cardiac transplant centres increases, there is an associated decrease in the availability of donor organs per centre. Subsequently, hospitals are utilizing cardiac assist systems (total artificial heart and ventricular assist devices) as a bridge to cardiac transplantation. Because of the engineering complexities related to the clinical implantation and follow up of these devices, a successful centre should have a well co-ordinated biomedical engineering programme. These engineers are responsible for the calibration, monitoring, and continued operation of these units. This paper is intended to serve as a guide to any centre interested in utilizing total artificial heart and ventricular assist systems, in particular the Novacor left ventricular assist system, and focuses on the management and function of the biomedical engineering component of our cardiac assist programme.

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References

Task Force on Organ Transplantation. Organ transplantation issues and recommendations. Report of the Task Force on Organ Transplantation. Washington: US Government Printing Office, 1988.

Report to the Chairman, Subcommittee on Health, Committee on Ways and Means, House of Representatives. Heart transplants: concerns about cost, access, and availability of donor organs. Washington: US General Accounting Office, 1989.

United Network for Organ Sharing (UNOS) , Richmond, VA.

The Working Group on Mechanical Circulatory Support; National Heart, Lung and Blood Institute. Artificial heart and assist devices: directions, needs, costs, societal and ethical issues. US Department of Health and Human Services publication no. (NIH) 85-2723, Public Health Service, 1985 .

DeVries WC The permanent artificial heart: four case reports. JAMA 1988; 259: 849-59.

Griffith BP , Kormos RL , Hardesty RL , Armitage JM , Dummer JS The artificial heart: infection related morbidity and its effect on transplantation . Ann Thorac Surg 1988; 45: 409-14.

Didisheim P. , Olsen DB , Farrar DJ et al. Infections and thromboembolism with implantable cardiovascular devices. Trans Am Soc Artif Intern Org 1989; 35 : 54-70.

Portner PM , Oyer PE , Pennington DG et al . Implantable electrical left ventricular assist system: bridge to transplantation and the future. Ann Thorac Surg 1989; 47 : 142-50.

Kormos RL , Borovetz HS , Gaisor T. et al . Experience with univentricular support in mortally ill cardiac transplant candidates. Ann Thorac Surg 1990; 49: 261-72.

10.

Novacor Left Ventricular Assist Manual (Rev. B). Novacor Division , Baxter Healthcare Corporation, Oakland, CA, 1987.

11.

Portner PM , Oyer PE , Jassawalla JS et al . A totally implantable ventricular assist device for end-stage heart disease. In: Unger F ed, Assisted circulation 2, Berlin: Springer Verlag, 1984: 115-41.

12.

Portner PM , Oyer PE , Jassawalla JS et al . An alternative in end-stage heart disease: long-term ventricular assistance. Heart Transplant 1983; 361: 47-59.

13.

Smith B. Novacor left ventricular assist system: nursing care plan (SICU) Nursing Inservice, Presbyterian University Hospital, Pittsburgh, PA, 1988.

14.

Hung T. , Butter D. , Kormos R. et al. Characteristics of blood rheology in patients during Novacor left ventricular assist system support. Trans Am Soc Artif Intern Organs 1989; 35: 611-13.

15.

Frattini PL , Wachter C. , Hung TC , Kormos RL , Griffith BP , Borovetz BP Erythrocyte deformability in patients on left ventricular assist systems (LVAS). Trans Am Soc Artif Intern Organs 1989; 35: 733-35.

16.

Mora E. , Kaplan SS , Hoffman R. , Simmons RL Biomaterial-centered infection: I. complement activation (Abstr). Am Soc Artif Intern Organs 1989; 18: 49.

17.

Eidelman BH , Obrist WD , Uretsky BF , Griffith BP , DeCeasare S. Cerebral blood flow in cardiac transplant patients. J Cereb Blood Flow Metab 1987; 7(Suppl 1)) : 45.