Issn Print: 1058-2916
Publication Date: 2003/03/01
A NEWLY DESIGNED INFLOW VALVE CONDUIT FOR THE THORATEC HEARTMATE XVE (IN-VIVO TESTING)
I D Gregoric; D Tamez; O Bataille; D L Byler; C J Cotter; D L Cowart; O H Frazier
+ Author Information
Author Information: Cullen CardioVascular Research Laboratories, Texas Heart Institute, Houston, TX
Excerpt
The Thoratec® HeartMate® XVE LVAD(XVE-L) has been redesigned to allow exchange of the inflow valve conduit after implantation without having to remove the device completely. We evaluated the exchange mechanism. Two acute studies were performed in a calf model to determine the feasibility of inflow conduit exchange. A sternotomy was made, CPB initiated, and a XVE-L was implanted. The LVAD was operated for 2 h, after which it was stopped, CPB was reinitiated, and the inflow conduit was exchanged using specially designed tools. A third study was performed in a cadaver to determine which of 3 surgical approaches (sternotomy, thoracotomy, or subdiaphragmatic incision) allowed the best results. In the calf studies, sternotomy allowed excellent thoracic exposure to rotate the tools and remove the inflow conduit. In the cadaver study, sternotomy was the most efficient approach, allowing excellent exposure to the inflow valve conduit and outflow graft. The thoracotomy approach also allowed successful conduit exchange but de-airing of the LVAD requires further studies. Subdiaphragmatic incision was the least successful approach, allowing only a restricted access to the conduit. Exchange of the inflow valve conduit in the redesigned XVE-L through a sternotomy, using the replacement tools is straightforward. This should allow the inflow valve conduit to be replaced without having to completely remove the device, thus minimizing surgical exposure and trauma. This should in turn enhance the long-term durability and performance of the XVE-L when used clinically.
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