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Device Options

Ideally, the choice of cardiac assist device used to treat end stage heart failure is determined by the needs of the individual patient. Columbia surgeons work with the most up-to-date devices available and carefully select the device best suited to each patient, based on their heart anatomy, heart health, and overall clinical history.

Some of the devices discussed below are implanted in the patient's body, while some operate from reside outside the patient's body. Read about how assist devices are connected to the body.

FDA-Approved Devices

Heartmate II Animation

The Thoratec HeartMate II, a smaller device, suitable for a wide range of patients including people of smaller stature, is designed to last up to 10 years.

The Thoratec HeartMate II^® Left Ventricular Assist Device (LVAD) is an implantable device intended for a broad range of advanced-stage heart failure patients. Heartmate is FDA-approved as permanent therapy (or destination therapy) for patients who are not eligible for transplantation; the device's hydrodynamic bearings are designed to provide up to 10 years of support. The HeartMate II is also used to support patients while they await transplantation (bridge to transplant). Its small size makes the device suitable for a wider range of patients, including those of smaller stature. The device provides blood flow through the circulatory system on a continual basis, and its automatic speed control mode regulates pumping activity based on different levels of patient or cardiac activity.

The HeartMate II is implanted just below the diaphragm in the abdomen. It is attached to the bottom of the left ventricle, and to the aorta just above the heart. The device draws blood from the weakened left ventricle and propels it into the aorta, leaving natural circulation in place while providing all of the energy necessary to send blood throughout the body. An external,wearable system that includes a controller and batteries is attached via an external driveline. A power cable connects the device to a small monitor, a power base unit.

Read about the clinical study that led to FDA approval of this device.

The Thoratec HeartMate XVE is used for both bridge-to-transplantation and destination therapy.

The Thoratec HeartMate XVE^® Left Ventricular Assist System is an implantable device for both bridge-to-transplantation therapy and destination therapy. The HeartMate XVE is widely recognized as having a low rate of blood clot complications among major VADs. HeartMate XVE patients can be discharged home from the ospital. The device's long leads and wearable system components facilitate freedom of movement, routine daily activities, travel and even some sports like golf — leading to an improved quality of life for patients.

The pump can be powered by a unit that plugs into the wall or by a wearable battery pack that allows greater mobility for the patient.

An extracorporeal (outside of the body) pump, the Thoratec VAD can be used as a bridge to transplantation or for shortterm support following surgery.

The Thoratec^® VAD system is the only system that provides left, right, or bi-ventricular assistance to patients with end stage heart failure. It has been FDA-approved as both a bridge-to-transplant therapy and for postcardiotomy recovery from open-heart surgery. The VADs are prosthetic ventricles which are composed of blood sacs inside of a hard plastic casing. A pressure/vacuum system allows air to enter the casing around the blood sac. This expansion and contraction of the air sacs allows the VAD to fill and eject blood, and provides the body with blood flow similar to that of the native heart. Thoractec VADs exist outside the body.

The CentriMag blood pump

Thoratec CentriMag^® Blood Pump
The CentriMag blood pump is an extracorporeal circulatory support device providing hemodynamic stabilization in patients in need of cardiopulmonary support. Cleared for clinical use up to six hours, CentriMag can be used as a short-term solution to support the circulation while longer-term options are considered.

Devices in Clinical Trials

Currently under investigation, the MicroMed DeBakey VAD potentially offers smaller size, reduced noise, and greater portability.

The goal of the impella recover, currently under investigation, is to provide a minimally invasive alternative for the temporary support of severe heart failure.

The MicroMed DeBakey VAD^® is a second-generation miniature heart pump designed to provide increased blood flow (up to 10L/min) from the left ventricle of the heart throughout the body for patients with end-stage heart failure. It can be used for both a bridgeto-transplantation and destination therapy. The device is only about three inches long and one inch wide. The smaller size results in reduced surgical time and offers treatment hope for patients with smaller body sizes, such as petite women and children. The DeBakey employs only one moving part–an impeller to pump blood throughout the body–making it quieter than many other devices. It also potentially offers patients greater mobility through the VADPAK, a portable controller and battery pack that powers the pump.

The impella^® recover is under investigation for the provision of temporary support to either or both sides of the heart in patients with severe heart failure. It offers the smallest and only minimally invasive mechanical cardiovascular support system, which can be inserted and removed through an incision in the groin. With a diameter of only 6.4 mm, the electric motor can pump 5 to 6 liters per minute, while potentially reducing the amount of damage to the blood, the need for hemodilution medications such as heparin, and the and the risk of infection. Specific systems include:

impella^®recover System for Biventricular Cardiovascular Support
impella^®recover LV for Left Ventricular Support
impella^®recover LV—peripheral for Left Ventricular Support
impella^®recover RV for Right Ventricular Support