Key result
In a hybrid simulator, the Infant Jarvik 2015 LVAD maintained adequate hemodynamics with low frequency of suction and backflow, suggesting suitability for patients weighing less than 8 kg.
Why the study?
Does the Infant Jarvik 2015 LVAD maintain adequate hemodynamics and stability in a hybrid simulator of patients weighing 2-7 kg?
Does the Infant Jarvik 2015 LVAD maintain adequate hemodynamics and stability in a hybrid simulator of patients weighing 2-7 kg?
In vitro hybrid simulation demonstrates that the Infant Jarvik 2015 LVAD is hemodynamically feasible and stable for infants weighing 2-7 kg.
Supports simulator feasibility of Infant Jarvik 2015 LVAD for 2-7 kg patients; leaves open clinical translation pending human trials.
Our aim was to study the feasibility of implanting the Infant Jarvik 2015 in patients weighing less than 8 kg. The Infant Jarvik 2015 left ventricular assist device (LVAD) was tested in a hybrid simulator of the cardiovascular system reproducing specific patients' hemodynamics for different patient weights (2-7 kg). For each weight, the sensitivity of the pump to different circulatory parameters (peripheral resistance, left ventricular elastance, right ventricular elastance, heart rate, and heart filling characteristics) has been tested repeating for each experiment a pump ramp (10 000-18 000 rpm). The increase in the pump speed causes a decrease (increase) in the left (right) atrial pressure, an increase (decrease) in the arterial systemic (pulmonary) pressure, an increase in the right ventricular pressure, a decrease (increase) in the left (right) ventricular volume, a decrease in the left ventricular cardiac output, an increase in the LVAD output and an increase in the right ventricular cardiac output (total cardiac output). Suction was observed for lower weight patients and for higher pump speed in the case of vasodilation, left ventricular recovery, bradycardia, right ventricular failure, and left ventricular hypertrophy. Backflow was observed in the case of left ventricular recovery at lower pump speed. In the hybrid simulator, the Infant Jarvik 2015 could be suitable for the implantation in patients lower than 8 kg because of the stability of the device respect to the cardio/circulatory changes (low frequency of suction and backflow) and because of the capability of the device to maintain adequate patient hemodynamics.
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Molfetta et al. (2018) studied Heart failure requiring LVAD support in infants. Infant Jarvik 2015 LVAD was evaluated on Feasibility and hemodynamic stability (suction, backflow, cardiac output). In a hybrid simulator, the Infant Jarvik 2015 LVAD maintained adequate hemodynamics with low frequency of suction and backflow, suggesting suitability for patients weighing less than 8 kg.
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