Modified tandemheart ventricular assist device for infant and pediatric circulatory support

Bradley T. Kulat; Hyde M. Russell; Anne E. Sarwark; Neale R. Zingle; Steven T. Moss; Michael C. Mongé; Carl L. Backer

doi:10.1016/j.athoracsur.2014.05.093

Modified tandemheart ventricular assist device for infant and pediatric circulatory support

Bradley T. Kulat^*, Hyde M. Russell, Anne E. Sarwark, Neale R. Zingle, Steven T. Moss, Michael C. Mongé, Carl L. Backer

^*Corresponding author for this work

Surgery, Cardiac Surgery Division

Research output: Contribution to journal › Article › peer-review

24 Scopus citations

Abstract

Purpose. The development of pediatric ventricular assist device (VAD) circuits withlower flow ranges for infants and small children is ongoing. We present our results withmodifying a readily available adult VAD to support the pediatric population.

Description. The TandemHeart VAD (CardiacAssist, Pittsburgh, PA) circuit was modifiedto include a variable restrictive recirculation shunt to permit lower flow ranges in smallpediatric patients.

Evaluation. Initial benchtop flow rates and pressures were studied. Hemolysis trials wereperformed using whole bovine blood to compare plasmaEvaluation. Initial benchtop flow rates-free hemoglobin levels betweenmodified and unmodified VAD circuits. The modified VAD was surgically implanted in 7piglets (6 to 14 kg) and which supported them for 4 hours. Levels of hemolysis did notincrease and full hemodynamic support was achieved. The modified TandemHeart VADwith a recirculation shunt was subsequently implanted in 2 pediatric patients who werebridged to transplant successfully.

Conclusions. Because of its simplicity, availability, low prime volume, greater patientflow range, and lower cost, the modified TandemHeart VAD with a recirculation shuntshould be considered as an alternative to extracorporeal membrane oxygenation and otherpulsatile VADs in children.

Original language	English (US)
Pages (from-to)	1437-1441
Number of pages	5
Journal	Annals of Thoracic Surgery
Volume	98
Issue number	4
DOIs	https://doi.org/10.1016/j.athoracsur.2014.05.093
State	Published - Oct 1 2014

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine
Pulmonary and Respiratory Medicine
Surgery

Access to Document

10.1016/j.athoracsur.2014.05.093

Cite this

@article{efd1b4fba993411dbffc11d3ae7f62c9,

title = "Modified tandemheart ventricular assist device for infant and pediatric circulatory support",

abstract = "Purpose. The development of pediatric ventricular assist device (VAD) circuits withlower flow ranges for infants and small children is ongoing. We present our results withmodifying a readily available adult VAD to support the pediatric population.Description. The TandemHeart VAD (CardiacAssist, Pittsburgh, PA) circuit was modifiedto include a variable restrictive recirculation shunt to permit lower flow ranges in smallpediatric patients.Evaluation. Initial benchtop flow rates and pressures were studied. Hemolysis trials wereperformed using whole bovine blood to compare plasmaEvaluation. Initial benchtop flow rates-free hemoglobin levels betweenmodified and unmodified VAD circuits. The modified VAD was surgically implanted in 7piglets (6 to 14 kg) and which supported them for 4 hours. Levels of hemolysis did notincrease and full hemodynamic support was achieved. The modified TandemHeart VADwith a recirculation shunt was subsequently implanted in 2 pediatric patients who werebridged to transplant successfully.Conclusions. Because of its simplicity, availability, low prime volume, greater patientflow range, and lower cost, the modified TandemHeart VAD with a recirculation shuntshould be considered as an alternative to extracorporeal membrane oxygenation and otherpulsatile VADs in children.",

author = "{T. Kulat}, Bradley and Russell, {Hyde M.} and Sarwark, {Anne E.} and {R. Zingle}, Neale and Moss, {Steven T.} and Mong{\'e}, {Michael C.} and Backer, {Carl L.}",

note = "Publisher Copyright: {\textcopyright} 2014 by The Society of Thoracic Surgeons.",

year = "2014",

month = oct,

day = "1",

doi = "10.1016/j.athoracsur.2014.05.093",

language = "English (US)",

volume = "98",

pages = "1437--1441",

journal = "Annals of Thoracic Surgery",

issn = "0003-4975",

publisher = "Elsevier Inc.",

number = "4",

}

TY - JOUR

T1 - Modified tandemheart ventricular assist device for infant and pediatric circulatory support

AU - T. Kulat, Bradley

AU - Russell, Hyde M.

AU - Sarwark, Anne E.

AU - R. Zingle, Neale

AU - Moss, Steven T.

AU - Mongé, Michael C.

AU - Backer, Carl L.

PY - 2014/10/1

Y1 - 2014/10/1

N2 - Purpose. The development of pediatric ventricular assist device (VAD) circuits withlower flow ranges for infants and small children is ongoing. We present our results withmodifying a readily available adult VAD to support the pediatric population.Description. The TandemHeart VAD (CardiacAssist, Pittsburgh, PA) circuit was modifiedto include a variable restrictive recirculation shunt to permit lower flow ranges in smallpediatric patients.Evaluation. Initial benchtop flow rates and pressures were studied. Hemolysis trials wereperformed using whole bovine blood to compare plasmaEvaluation. Initial benchtop flow rates-free hemoglobin levels betweenmodified and unmodified VAD circuits. The modified VAD was surgically implanted in 7piglets (6 to 14 kg) and which supported them for 4 hours. Levels of hemolysis did notincrease and full hemodynamic support was achieved. The modified TandemHeart VADwith a recirculation shunt was subsequently implanted in 2 pediatric patients who werebridged to transplant successfully.Conclusions. Because of its simplicity, availability, low prime volume, greater patientflow range, and lower cost, the modified TandemHeart VAD with a recirculation shuntshould be considered as an alternative to extracorporeal membrane oxygenation and otherpulsatile VADs in children.

AB - Purpose. The development of pediatric ventricular assist device (VAD) circuits withlower flow ranges for infants and small children is ongoing. We present our results withmodifying a readily available adult VAD to support the pediatric population.Description. The TandemHeart VAD (CardiacAssist, Pittsburgh, PA) circuit was modifiedto include a variable restrictive recirculation shunt to permit lower flow ranges in smallpediatric patients.Evaluation. Initial benchtop flow rates and pressures were studied. Hemolysis trials wereperformed using whole bovine blood to compare plasmaEvaluation. Initial benchtop flow rates-free hemoglobin levels betweenmodified and unmodified VAD circuits. The modified VAD was surgically implanted in 7piglets (6 to 14 kg) and which supported them for 4 hours. Levels of hemolysis did notincrease and full hemodynamic support was achieved. The modified TandemHeart VADwith a recirculation shunt was subsequently implanted in 2 pediatric patients who werebridged to transplant successfully.Conclusions. Because of its simplicity, availability, low prime volume, greater patientflow range, and lower cost, the modified TandemHeart VAD with a recirculation shuntshould be considered as an alternative to extracorporeal membrane oxygenation and otherpulsatile VADs in children.

UR - http://www.scopus.com/inward/record.url?scp=84908065789&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84908065789&partnerID=8YFLogxK

U2 - 10.1016/j.athoracsur.2014.05.093

DO - 10.1016/j.athoracsur.2014.05.093

M3 - Article

C2 - 25282205

AN - SCOPUS:84908065789

SN - 0003-4975

VL - 98

SP - 1437

EP - 1441

JO - Annals of Thoracic Surgery

JF - Annals of Thoracic Surgery

IS - 4

ER -

Modified tandemheart ventricular assist device for infant and pediatric circulatory support

Abstract

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Cite this