Abstract
Our 15-year experience of the Toyobo paracorporeal left ventricular assist system (LVAS) at Osaka University Hospital was reviewed. In total, 61 patients underwent Toyobo LVAS implantation from January 1992 to August 2007. Their mean age was 38.1 ± 16.9 years. The etiologies of heart failure were idiopathic dilated cardiomyopathy in 35 patients, ischemic cardiomyopathy in 15, myocarditis in 5, secondary cardiomyopathy in 4, and others in 2. Preoperatively, intubation was required in 41 patients (67.3%), an intra-aortic balloon pump was required in 38 (62.3%), and extracorporeal membrane oxygenation was required in 30 (49.2%). Four patients underwent heart transplantation and 11 underwent LVAS removal. Of those 11 patients, 4 were subjected to emergent removal because of device complications and all of them died. Of the 7 patients that underwent scheduled LVAS removal, heart failure recurred in 2 patients and reimplantation was required. In terms of major device-related complications, cerebral hemorrhage occurred in 16 patients (26.2%), cerebral infarction in 19 (31.1%), mediastinitis in 10 (16.4%), and inflow/outflow cannula exit site infection in 19 patients (31.1%). The actuarial survival rate of the patients operated on in the last 5 years of this study was 66.3% at 6 months and 45.9% at 1 year. Although the survival rate of patients supported by the Toyobo LVAS has recently improved, the morbidity rate is significant. Considering the current severe shortage of heart donors in Japan, it is important to introduce more durable devices with fewer complications and to establish the strategies for using the LVAS as a bridge to recovery.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Takano H, Taenaka Y, Nakatani T, Umezu M. Development and evaluation of ventricular assist blood pump to salvage patients with profound heart failure. J Jpn Assoc Thorac Surg 1989;37:2072–2081
Taenaka Y, Takano H, Nakatani T, Umezu M, Tanaka T, Akutsu T, Naito Y, Manabe H. Ventricular assist device (LVAD) for children: in vitro and in vivo evaluation. Trans Am Soc Artif Intern Organs 1984;30:155–158
Matsuda T, Takano H, Hayashi K, Taenaka Y, Takaichi S, Umezu M, Nakamura T, Iwata H, Nakatani T, Tanaka T, Takatani S, Akutsu T. The blood interface with segmented polyurethanes: multilayered protein passivation mechanism. Trans Am Soc Artif Intern Organs 1984;30:353–357
Takano H, Nakatani T, Taenaka Y, Kitoh Y, Hiramori K, Haze K, Itoh A, Fujita T, Manabe H. Treatment of acute profound heart failure by ventricular assist system. Jpn Circ J 1992;56:100–110
Takano H, Taenaka Y, Noda H, Kinoshita M, Yagura A, Tatsumi E, Seki H, Sasaki E, Umezu M, Nakatani T, Kyo S, Omoto R, Akutsu T, Manabe H. Multi-institutional studies of the national cardiovascular center ventricular assist systems: use in 92 patients. Trans Am Soc Artif Intern Organs 1989;35:541–544
Takano H, Nakatani T. Ventricular assist systems: experience in Japan with Toyobo pump and Zeon pump. Ann Thorac Surg 1996;61:317–322
Matsuwaka R, Matsuda H, Kaneko M, Masai T, Miyamoto Y, Sakakibara T. Overseas transport of a patient with an extracorporeal left ventricular assist device. Ann Thorac Surg 1995;59:522–523
Masai T, Simazaki Y, Kadoba K, Miyamoto Y, Sawa Y, Yagura A, Matsuda H, Satoh M, Kashiwabara S. Clinical experience with long-term use of Toyobo left ventricular assist system. ASAIO J 1995;41:M522–525
McBride LR, Naunheim KS, Fiore AC, Moroney DA, Swartz MT. Clinical experience with 111 Thoratec ventricular assist devices. Ann Thorac Surg 1999;67:1233–1239
Schmid C, Tjan T, Etz C, Welp H, Rukosujew A, Klotz S, Drees G, Gogarten W, Scheld HH. The Excor device — revival of an old system with excellent results. Thorac Cardiovasc Surg 2006;54:393–399
Zierer A, Melby SJ, Voeller RK, Guthrie TJ, Ewald GA, Shelton K, Pasque MK, Moon MR, Damiano RJ, Moazami N. Late-onset driveline infections: the Achilles’ heel of prolonged left ventricular assist device support. Ann Thorac Surg 2007;84:515–521
Reedy JE, Swartz MT, Pennington DG, McBride LR, Miller LW, Ruzevich SA. Bridge to cardiac transplantation: importance of patient selection. J Heart Transplant 1990;9:473–481
Pennington DG, McBride LR, Peigh PS, Miller LW, Swartz MT. Eight years’ experience with bridging to cardiac transplantation. J Thorac Cardiovasc Surg 1994;107:472–481
Kucuker SA, Stetson SJ, Becker KA, Akgül A, Loebe M, Lafuente JA, Noon GP, Koerner MM, Entman ML, Torre-Amione G. Evidence of improved right ventricular structure after LVAD support in patients with end-stage cardiomyopathy. J Heart Lung Transplant 2004;23:28–35
Goldstein DJ, Oz MC, Rose EA. Implantable left ventricular assist devices. N Engl J Med 1998;339:1522–1533
Frazier OH, Rose EA, Macmanus Q, Burton NA, Lefrak EA, Poirier VL, Dasse KA. Multicenter clinical evaluation of the HeartMate 1000 IP left ventricular assist device. Ann Thorac Surg 1992;53:1080–1090
Dang NC, Topkara VK, Mercando M, Kay J, Kruger KH, Aboodi MS, Oz MC, Naka Y. Right heart failure after left ventricular assist device implantation in patients with chronic congestive heart failure. J Heart Lung Transplant 2006;25:1–6
Ochiai Y, McCarthy PM, Smedira NG, Banbury MK, Navia JL, Feng J, Hsu AP, Yeager ML, Buda T, Hoercher KJ, Howard MW, Takagaki M, Doi K, Fukamachi K. Predictors of severe right ventricular failure after implantable left ventricular assist device insertion: analysis of 245 patients. Circulation 2002;106:I198–202
Deng MC, Edwards LB, Hertz MI, Rowe AW, Keck BM, Kormos R, Nafter DC, Kirklin JK. Mechanical circulatory support device database of the International Society for Heart and Lung Transplantation: second annul report — 2004. J Heart Lung Transplant 2004;23:1027–1034
Tsukui H, Teuteberg JJ, Murali S, McNamara DM, Buchanan JR, Winowich S, Stanford E, Mathier MA, Cadaret LM, Kormos RL. Biventricular assist device utilization for patients with morbid congestive heart failure. A justifiable strategy. Circulation 2005;112:I65–72
Slaughter MS, Sobiesky MA, Martin M, Dia M, Silver M. Home discharge experience with the Thoratec TLC-II portable driver. ASAIO J 2007;53:132
Nishimura M, Ogiwara M, Ishikawa M, Imanaka K, Okamura N, Kato M, Asano H, Katogi T, Kohmoto O, Matsumoto K, Nishimura S, Kyo S. Successful bridge to resynchronization therapy with a left ventricular assist system in a patient with idiopathic dilated cardiomyopathy. J Artif Organs 2005;8:210–213
Hata H, Matsumiya G, Miyagawa S, Kondoh H, Kawaguchi N, Matsuura N, Shimizu T, Okano T, Matsuda H, Sawa Y. Grafted skeletal myoblast sheets attenuated myocardial remodeling in pacing-induced canine heart failure model. J Thorac Cardiovasc Surg 2006;132:918–924
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Saito, S., Matsumiya, G., Sakaguchi, T. et al. Fifteen-year experience with Toyobo paracorporeal left ventricular assist system. J Artif Organs 12, 27–34 (2009). https://doi.org/10.1007/s10047-009-0448-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10047-009-0448-5