Is the New Infant Jarvik 2015 Suitable for Patients<8 kg? In Vitro Study Using a Hybrid Simulator

Arianna Di Molfetta, Krzysztof Zielinski, Gianfranco Ferrari, Macej Kozarski, Piotr Okrzeja, Roberta Iacobelli, Sergio Filippelli, Gianluigi Perri, Marek Darowski, Massimo Massetti, Robert Jarvik, Antonio Amodeo

Research output: Contribution to journalArticle

Abstract

Our aim was to study the feasibility of implanting the Infant Jarvik 2015 in patients weighing less than 8 kg. The Infant Jarvik 2015 left ventricular assist device (LVAD) was tested in a hybrid simulator of the cardiovascular system reproducing specific patients’ hemodynamics for different patient weights (2–7 kg). For each weight, the sensitivity of the pump to different circulatory parameters (peripheral resistance, left ventricular elastance, right ventricular elastance, heart rate, and heart filling characteristics) has been tested repeating for each experiment a pump ramp (10 000–18 000 rpm). The increase in the pump speed causes a decrease (increase) in the left (right) atrial pressure, an increase (decrease) in the arterial systemic (pulmonary) pressure, an increase in the right ventricular pressure, a decrease (increase) in the left (right) ventricular volume, a decrease in the left ventricular cardiac output, an increase in the LVAD output and an increase in the right ventricular cardiac output (total cardiac output). Suction was observed for lower weight patients and for higher pump speed in the case of vasodilation, left ventricular recovery, bradycardia, right ventricular failure, and left ventricular hypertrophy. Backflow was observed in the case of left ventricular recovery at lower pump speed. In the hybrid simulator, the Infant Jarvik 2015 could be suitable for the implantation in patients lower than 8 kg because of the stability of the device respect to the cardio/circulatory changes (low frequency of suction and backflow) and because of the capability of the device to maintain adequate patient hemodynamics.

Original languageEnglish
JournalArtificial Organs
DOIs
Publication statusAccepted/In press - Jan 1 2018

Keywords

  • Hybrid model
  • Infant Jarvik 2015
  • Lumped parameter models
  • Pediatric
  • Ventricular assist device

ASJC Scopus subject areas

  • Bioengineering
  • Medicine (miscellaneous)
  • Biomaterials
  • Biomedical Engineering

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    Di Molfetta, A., Zielinski, K., Ferrari, G., Kozarski, M., Okrzeja, P., Iacobelli, R., Filippelli, S., Perri, G., Darowski, M., Massetti, M., Jarvik, R., & Amodeo, A. (Accepted/In press). Is the New Infant Jarvik 2015 Suitable for Patients<8 kg? In Vitro Study Using a Hybrid Simulator. Artificial Organs. https://doi.org/10.1111/aor.13302