The Jarvik 2000 left ventricular assist device as a bridge to transplantation: Japanese Registry for Mechanically Assisted Circulatory Support

Hiroki Kohno, Goro Matsumiya, Yoshiki Sawa, Minoru Ono, Yoshikatsu Saiki, Akira Shiose, Kenji Yamazaki, Yoshiro Matsui, Hiroshi Niinami, Hikaru Matsuda, Soichiro Kitamura, Takeshi Nakatani, Shunei Kyo

Research output: Contribution to journalArticlepeer-review

11 Citations (Scopus)

Abstract

Background The Jarvik 2000 ventricular assist device features a miniaturized intraventricular pump and an intermittent low-speed function that facilitates aortic valve opening. Despite its long history, little is known about the Jarvik device with regard to post-implantation outcomes. Methods Prospectively collected data from 13 participating hospitals were extracted from the Japanese Registry for Mechanically Assisted Circulatory Support database to analyze mortality, morbidity and de-novo aortic regurgitation. Data on 83 patients who underwent implantation of the Jarvik 2000 were reviewed. Median support duration was 191 (maximum 758) days. All recipients underwent implantation as a bridge to transplantation. Results Overall survival proportions at 1 and 2 years were 85.0% and 79.3%, respectively. Nine patients were in INTERMACS Level 1, and 28 patients were on mechanical circulatory support at the time of implantation. Causes of death included stroke, infection and device malfunction. Three patients had their device removed: 2 at the time of heart transplantation and 1 after recovery of the left ventricle. Common adverse events included major bleeding (27.7%), new infection (31.3%), stroke (20.5%) and device malfunction (20.5%). De-novo aortic regurgitation was observed in 17 patients, 6 of whom developed at least moderate regurgitation during follow-up. Conclusions Mid-term survival after Jarvik 2000 implantation was satisfactory and comparable to that reported by other national and international registries (INTERMACS and IMACS) for continuous-flow LVADs. De novo aortic regurgitation occurred despite the intermittent low-speed effect of this device, with some recipients experiencing progressive worsening of aortic regurgitation within 2 years post-implantation.

Original languageEnglish
Pages (from-to)71-78
Number of pages8
JournalJournal of Heart and Lung Transplantation
Volume37
Issue number1
DOIs
Publication statusPublished - 2018 Jan

Keywords

  • Jarvik 2000
  • LVAD
  • aortic regurgitation
  • bridge-to-transplantation
  • continuous-flow ventricular assist device
  • follow-up
  • post-implantation outcome

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine
  • Transplantation

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