Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy.
Cardiac Surgery, University of Chieti, Chieti, Italy.
Artif Organs. 2022 Dec;46(12):2486-2492. doi: 10.1111/aor.14368. Epub 2022 Aug 30.
We investigated the synergistic effect of the new cone-bearing design of Jarvik 2000 (Jarvik Heart Inc., NY) together with a minimally-invasive approach to outcomes of LVAD patients.
We retrospectively reviewed all patients from 5 institutions involved in the Jarvik 2000 Italian Registry, from October 2008 to October 2016. Patients were divided into three groups according to pump design and implantation technique: pin-bearing design and conventional approach (Group 1); cone-bearing and conventional approach (Group 2); cone-bearing and minimally-invasive implantation (Group 3).
A total of 150 adult patients with end-stage heart failure were enrolled: 26 subjects in Group 1, 74 in Group 2, and 50 in Group 3. Nineteen patients (73%) in Group 1, 51 (69%) in Group 2, and 36 (72%) in Group 3 were discharged. During follow-up, 22 patients underwent transplantation, while in 3 patients the LVAD was explanted. The overall 1-year survival was 58 ± 10%, 64 ± 6%, and 74% ± 7% in Groups 1, 2, and 3, respectively (p = 0.034). The competing-risks-adjusted cumulative incidence rate for adverse events was 42.1 [27-62.7] per 100 patient-years in Group 1, 35.4 [25.3-48.2] in Group 2, and 22.1 [12.4-36.4] in Group 3 (p = 0.046 for Group 1 vs. 3).
The association of the modern cone-bearing configuration of Jarvik 2000 and minimally invasive surgery improved survival and minimized the risk for cardiovascular events, as a result of combining technology and technique.
我们研究了新型带圆锥设计的 Jarvik 2000 （Jarvik 心脏公司，纽约）与微创方法相结合对 LVAD 患者结果的协同效应。
我们回顾性分析了 2008 年 10 月至 2016 年 10 月参与 Jarvik 2000 意大利注册研究的 5 家机构的所有患者。根据泵的设计和植入技术，患者被分为三组：销钉轴承设计和传统方法（第 1 组）；圆锥轴承和传统方法（第 2 组）；圆锥轴承和微创植入（第 3 组）。
共纳入 150 例终末期心力衰竭的成年患者：第 1 组 26 例，第 2 组 74 例，第 3 组 50 例。第 1 组 19 例（73%），第 2 组 51 例（69%），第 3 组 36 例（72%）出院。随访期间，22 例患者接受了移植，3 例患者 LVAD 被取出。第 1、2、3 组的 1 年总生存率分别为 58±10%、64±6%和 74%±7%（p=0.034）。第 1 组的不良事件累积发生率为 42.1[27-62.7]每 100 患者年，第 2 组为 35.4[25.3-48.2]，第 3 组为 22.1[12.4-36.4]（p=0.046，第 1 组与第 3 组比较）。
Jarvik 2000 的现代圆锥设计和微创手术的结合，通过技术和技术的结合，提高了生存率，降低了心血管事件的风险。
