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Novel temporary left ventricular assist system with hydrodynamically levitated bearing pump for bridge to decision: initial preclinical assessment in a goat model

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  • Artificial Heart (Basic)
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Abstract

The management of heart failure patients presenting in a moribund state remains challenging, despite significant advances in the field of ventricular assist systems. Bridge to decision involves using temporary devices to stabilize the hemodynamic state of such patients while further assessment is performed and a decision can be made regarding patient management. We developed a new temporary left ventricular assist system employing a disposable centrifugal pump with a hydrodynamically levitated bearing. We used three adult goats (body weight, 58–68 kg) to investigate the 30-day performance and hemocompatibility of the newly developed left ventricular assist system, which included the pump, inflow and outflow cannulas, the extracorporeal circuit, and connectors. Hemodynamic, hematologic, and blood chemistry measurements were investigated as well as end-organ effect on necropsy. All goats survived for 30 days in good general condition. The blood pump was operated at a rotational speed of 3000–4500 rpm and a mean pump flow of 3.2 ± 0.6 L min. Excess hemolysis, observed in one goat, was due to the inadequate increase in pump rotational speed in response to drainage insufficiency caused by continuous contact of the inflow cannula tip with the left ventricular septal wall in the early days after surgery. At necropsy, no thrombus was noted in the pump, and no damage caused by mechanical contact was found on the bearing. The newly developed temporary left ventricular assist system using a disposable centrifugal pump with hydrodynamic bearing demonstrated consistent and satisfactory hemodynamic performance and hemocompatibility in the goat model.

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References

  1. Rose EA, Gelijns AC, Moskowitz AJ, Heitjan DF, Stevenson LW, Dembitsky W, et al. Long-term use of a left ventricular assist device for end-stage heart failure. N Engl J Med. 2001;345:1435–43.

    Article  CAS  PubMed  Google Scholar 

  2. Slaughter MS, Rogers JG, Milano CA, Russell SD, Conte JV, Feldman D, et al. Advanced heart failure treated with continuous-flow left ventricular assist device. N Engl J Med. 2009;361:2241–51.

    Article  CAS  PubMed  Google Scholar 

  3. Slaughter MS, Singh R. The role of ventricular assist devices in advanced heart failure. Rev Esp Cardiol. 2012;65:982–5.

    Article  PubMed  Google Scholar 

  4. Puehler T, Ensminger S, Schoenbrodt M, Börgermann J, Rehn E, Hakim-Meibodi K, et al. Mechanical circulatory support devices as destination therapy-current evidence. Ann Cardiothorac Surg. 2014;3:513–24.

    PubMed  PubMed Central  Google Scholar 

  5. Boyle AJ, Ascheim DD, Russo MJ, Kormos RL, John R, Naka Y, et al. Clinical outcomes for continuous-flow left ventricular assist device patients stratified by pre-operative INTERMACS classification. J Heart Lung Transpl. 2011;30:402–7.

    Article  Google Scholar 

  6. Ziemba EA, John R. Mechanical circulatory support for bridge to decision: which device and when to decide. J Card Surg. 2010;25:425–33.

    Article  PubMed  Google Scholar 

  7. De Robertis F, Rogers P, Amrani M, Petrou M, Pepper JR, Bahrami T, et al. Bridge to decision using the Levitronix CentriMag short-term ventricular assist device. J Heart Lung Transpl. 2008;27:474–8.

    Article  Google Scholar 

  8. Takayama H, Soni L, Kalesan B, Truby LK, Ota T, Cedola S, et al. Bridge-to-decision therapy with a continuous-flow external ventricular assist device in refractory cardiogenic shock of various causes. Circ Heart Fail. 2014;7:799–806.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Borisenko O, Wylie G, Payne J, Bjessmo S, Smith J, Firmin R, et al. The cost impact of short-term ventricular assist devices and extracorporeal life support systems therapies on the National Health Service in the UK. Interact Cardiovasc Thorac Surg. 2014;19:41–8.

    Article  PubMed  Google Scholar 

  10. Kashiwa K, Nishimura T, Saito A, Kubo H, Fukaya A, Tamai H, et al. Left heart bypass support with the Rotaflow Centrifugal Pump® as a bridge to decision and recovery in an adult. J Artif Organs. 2012;15:207–10.

    Article  PubMed  Google Scholar 

  11. Khaliel F, Al Habeeb W, Saad E, Kjellman U. Use of Rotaflow pump for left ventricular assist device bridging for 15 weeks. Asian Cardiovasc Thorac Ann. 2014;22:205–7.

    Article  PubMed  Google Scholar 

  12. Hoshi H, Shinshi T, Takatani S. Third-generation blood pumps with mechanical noncontact magnetic bearings. Artif Organs. 2006;30:324–38.

    Article  PubMed  Google Scholar 

  13. Sawa Y. Current status of third-generation implantable left ventricular assist devices in Japan, Duraheart and HeartWare. Surg Today. 2015;45:672–81.

    Article  PubMed  Google Scholar 

  14. Tanaka H, Tsukiya T, Tatsumi E, Mizuno T, Hidaka T, Okubo T, et al. Initial in vivo evaluation of the newly developed axial flow turbo pump with hydrodynamic bearings. J Artif Organs. 2011;14:31–8.

    Article  PubMed  Google Scholar 

  15. Tsukiya T, Mizuno T, Takewa Y, Tatsumi E, Taenaka Y. Preclinical study of a novel hydrodynamically levitated centrifugal pump for long-term cardiopulmonary support: in vivo performance during percutaneous cardiopulmonary support. J Artif Organs. 2015;18:300–6.

    Article  PubMed  Google Scholar 

  16. Nishimura T. Current status of extracorporeal ventricular assist devices in Japan. J Artif Organs. 2014;17:211–9.

    Article  PubMed  Google Scholar 

  17. Mohite PN, Zych B, Popov AF, Sabashnikov A, Sáez DG, Patil NP, et al. CentriMag short-term ventricular assist as a bridge to solution in patients with advanced heart failure: use beyond 30 days. Eur J Cardiothorac Surg. 2013;44:e310–e5.

    Article  PubMed  Google Scholar 

  18. Takeda S, Kotani T, Nakagawa S, Ichiba S, Aokage T, Ochiai R, et al. Extracorporeal membrane oxygenation for 2009 influenza A(H1N1) severe respiratory failure in Japan. J Anesth. 2012;26:650–7.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Takauji S, Saito T, Sato T, Okada M, Kano H, Makise H, et al. A comparison between long- and short-term extracorporeal membrane oxygenation. [Long-term ECMO 症例と short-term ECMO 症例の比較検討]. Jpn J Respir Care. 2014;31:45–9 (Japanese).

    Google Scholar 

  20. Date K, Kishimoto S, Fujii Y, Togo K, Kakuta Y, Mizuno T, et al. Effects of feeding state on anticoagulation in adult goats treated with warfarin. J Artif Organs 2016;19301–4.

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Acknowledgements

This work was supported by the Early-Stage & Exploratory Clinical Trials project funded by the Ministry of Health, Labour and Welfare of Japan.

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Authors and Affiliations

  1. Department of Artificial Organs, National Cerebral and Cardiovascular Center Research Institute, 5-7-1 Fujishiro-dai, Suita, Osaka, 565-8565, Japan

    Satoru Kishimoto, Yoshiaki Takewa, Tomonori Tsukiya, Toshihide Mizuno, Kazuma Date, Hirohito Sumikura, Yutaka Fujii, Kentaro Ohnuma, Konomi Togo, Nobumasa Katagiri, Noritsugu Naito & Eisuke Tatsumi

  2. Division of Organ Regeneration Surgery, Department of Surgery, Faculty of Medicine, Tottori University, Tottori, Japan

    Satoru Kishimoto, Yuichiro Kishimoto, Yoshinobu Nakamura & Motonobu Nishimura

Authors
  1. Satoru Kishimoto
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  2. Yoshiaki Takewa
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  3. Tomonori Tsukiya
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  4. Toshihide Mizuno
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  5. Kazuma Date
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  6. Hirohito Sumikura
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  7. Yutaka Fujii
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  8. Kentaro Ohnuma
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  9. Konomi Togo
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  10. Nobumasa Katagiri
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  11. Noritsugu Naito
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  12. Yuichiro Kishimoto
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  13. Yoshinobu Nakamura
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  14. Motonobu Nishimura
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  15. Eisuke Tatsumi
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Corresponding authors

Correspondence to Satoru Kishimoto or Eisuke Tatsumi.

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Conflict of interest

The National Cerebral and Cardiovascular Center (principal investigator: Eisuke Tatsumi) and Nipro Corp. (Osaka, Japan) have a joint research agreement. The funders had no role in the study design, data collection and analysis, interpretation of results, manuscript preparation, or decision to publish.

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Kishimoto, S., Takewa, Y., Tsukiya, T. et al. Novel temporary left ventricular assist system with hydrodynamically levitated bearing pump for bridge to decision: initial preclinical assessment in a goat model. J Artif Organs 21, 23–30 (2018). https://doi.org/10.1007/s10047-017-0989-y

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  • DOI: https://doi.org/10.1007/s10047-017-0989-y

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