JOURNAL HOME CME HOME THIS MONTH PAST ISSUES ETOC COLLECTIONS AUTHORS REVIEWERS EDITORIAL BOARD FEEDBACK RSS HELP
		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (3) Citing Articles via Google Scholar Google Scholar Articles by Nussmeier, N. A. Articles by Frazier, O. H. Search for Related Content PubMed PubMed Citation Articles by Nussmeier, N. A. Articles by Frazier, O. H. Related Collections Cardiovascular Equipment Anesthetic Techniques Monitoring (Cardiac)

---

CARDIOVASCULAR ANESTHESIA

Anesthetic Management for Implantation of the Jarvik 2000^TM Left Ventricular Assist System

Nancy A. Nussmeier, MD^*, Charles B. Probert, MD^*, Douglas Hirsch, MD^*, John R. Cooper, Jr., MD^*, Igor D. Gregoric, MD, Timothy J. Myers, BS, and O. H. Frazier, MD

*Department of Cardiovascular Anesthesiology and The Cullen Cardiovascular Surgical Research Laboratories, Texas Heart Institute at St. Luke’s Episcopal Hospital, Houston, Texas

Address correspondence and reprint requests to Dr. Nussmeier, Department of Cardiovascular Anesthesiology, Texas Heart Institute at St. Luke’s Episcopal Hospital, PO Box 20345, MC1-226, Houston, TX 77030. Address email to nnussmeier{at}heart.thi.tmc.edu

The Jarvik 2000 Heart^TM is a left ventricular assist device that produces continuous nonpulsatile axial flow by means of a single, rotating, vaned impeller. Anesthetic and perioperative considerations of the Jarvik 2000 Heart^TM differ from those of conventional assist devices. The Jarvik 2000 is implanted within the left ventricle through a left thoracotomy, which is aided by left lung isolation. A brief period of cardiopulmonary bypass and induced ventricular fibrillation facilitate implantation. Transesophageal echocardiography is essential to assure proper intraventricular positioning of the device and aortic outflow, confirmed by observation of aortic valve opening in the presence of adequate left ventricular volume. Because continuous flow devices function best in the presence of lower systemic and pulmonary vascular resistance, milrinone was preferentially used as an inotropic drug. In the first group of 10 patients to receive the Jarvik 2000, the pump provided a cardiac output of up to 8 L/min, depending on preload, afterload, and pump speed. There were no early perioperative deaths. The average support duration was 81.2 days; the range was 13–214 days. Seven of the 10 patients survived to transplantation. Survivors underwent complete physical rehabilitation during pump support.

IMPLICATIONS: The Jarvik 2000 is a left ventricular assist device that produces continuous nonpulsatile axial flow by means of a rotating, vaned impeller. Because the anesthetic considerations differ from those of conventional left ventricular assist devices, we report the perioperative management of the first 10 patients who participated in a bridge-to-transplantation feasibility study of the Jarvik 2000.

This article has been cited by other articles:

				S. Chumnanvej, M. J. Wood, T. E. MacGillivray, and M. F. V. Melo Perioperative Echocardiographic Examination for Ventricular Assist Device Implantation Anesth. Analg., September 1, 2007; 105(3): 583 - 601. [Abstract] [Full Text] [PDF]

				S. Scolletta, I. D Gregoric, L. Muzzi, B. Radovancevic, and O H. Frazier Pulse wave analysis to assess systemic blood flow during mechanical biventricular support Perfusion, January 1, 2007; 22(1): 63 - 66. [Abstract] [PDF]

				I. El-Magharbel Ventricular Assist Devices and Anesthesia Seminars in Cardiothoracic and Vascular Anesthesia, September 1, 2005; 9(3): 241 - 249. [Abstract] [PDF]

Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999