Jarvik 2000 Successful in Patients Awaiting Heart Transplantation

The Jarvik 2000, a left ventricular assist device, appears to be a useful bridge therapy for patients waiting to undergo heart transplantation.

In a May 28th rapid track report from Circulation: Journal of the American Heart Association, Dr. O. H. Frazier, from the Texas Heart Institute in Houston, and colleagues describe the results of the Jarvik 2000 in 10 heart transplantation candidates. Patients in the study were a mean 51.3 years of age and had a New York Heart Association (NYHA) functional class IV.

Forty-eight hours after the device was implanted, average cardiac index rose by 43% and the pulmonary capillary wedge pressure fell by 52%, the researchers report. Systemic vascular resistance also significantly decreased and patients no longer needed inotropic support.

Of eight patients who underwent physical rehabilitation, all returned to NYHA functional class I. Dr. Frazier’s team found that measurement of ventricular dimensions, cardiothoracic ratios and pressure-volume loop analysis all showed good left ventricular unloading.

The average period of Jarvik 2000 support was 84 days. Seven patients underwent heart transplantation and the other three died while awaiting transplantation. Throughout the trial, no device-related thrombosis seen, Dr. Frazier’s group notes.

“The Jarvik 2000 was designed to be reliable, easy to implant and simple to operate. In our series of 10 patients, the device met all of these goals,” Dr. Frazier and colleagues conclude.

“At this early stage, the Jarvik 2000 seems to hold much promise for many patients with heart failure. This series showed that it can safely support patients to transplantation,” Dr. Denton A. Cooley, who is also from the Texas Heart Institute, comments in a journal editorial.

“The low operative risk associated with this pump may also make it a possible destination therapy for patients who are either refractory to medical therapy or whose conditions deteriorate rapidly,” he adds.

The Jarvik 2000 has been use as destination therapy by UK-based team, which recently reported good preliminary results in a small group of patients (see Reuters Health report May 17, 2002.)