CARDIOVASCULAR JOURNAL OF AFRICA • Volume 27, No 4, July/August 2016
States Food and Drug Administration (FDA) and Conformit
enne (CE), and have been on the market for a long time.
Many centres have implanted these pumps in their end-stage
heart failure patients all over the world.
Long-term outcomes of these pumps have been published
recently in the literature.
modified Micromed axial flow pump has an
approaching that of the natural heart.
that the thrombogenicity of Heart Assist 5 was 2.5-fold lower
than the HeartMate II LVAD.
Although our experience with Heart Assist 5 LVAD was not
from a large series, compared with other continuous-flow and
centrifugal pumps that we have implanted in our clinic, we tried
to standardise pre-operative LVAD evaluations and post-implant
follow up of LVAD patients in collaboration with the heart
failure cardiologists. We believe that as a heart failure/transplant
team, a systematic approach for the evaluation of these patients
suffering from advanced heart failure is important. Close follow
up of these patients will affect the success of LVAD surgery
and long-term prognosis of the patients, which will lessen the
side effects and enable rapid and accurate identification of
mechanical and systemic malfunctions.
Our group was the first to implant this version of Heart
Assist 5 LVAD in Turkey. An earlier version of this pump was
implanted in Turkey in April 2001.
There were no data in the
literature on the Heart Assist 5 LVAD using echocardiographic
parameters and LVAD optimisation protocols during long-term
follow up of the patients. In our clinical studies we were able
to visualise the inflow cannula and outflow graft anastomoses
to the aorta in most of the echocardiographic studies. The
remote monitoring system and the implantable flow probe
measurements were reliable, and tracking and monitoring of
these patients outside of hospital was easy.
Our study has limitations since there were so few patients with
Heart Assist 5 LVAD support in our group. However, if other
centres start implanting Heart Assist 5 LVAD in their end-stage
heart failure patients, more data on these pumps and their long-
term outcome will be available for clinicians in the future. This
pump has had CE approval in Europe since May 2009, and the
National Health Government solved the reimbursement issues
of these continuous-flow pumps in 2012.
Our study was not designed for the appropriate combination of
flow, power, pulsatily index and left ventricular unloading. It is
impossible to establish or document cause–effect relationships
while optimising LVAD parameters with so few patients. This
study was an observational analysis of a new-generation pump.
We believe that a concept should be studied in larger prospective
series with different pumps using serial echocardiographic
studies and comparing long-term outcomes of each pump.
Ammar KA, Umdal MM, Kramer C, Sulamanjee N, Jan FM,
. The ABCs of left ventricular assist device echo-
cardiography: a systemic approach.
Eur Heart J Cardiovasc Imaging
Kato TS, Farr M, Schulze PC, Maurer M, Shahzad K, Iwata S,
Usefulness of two-dimensional echocardiographic parameters of the left
side of the heart to predict right ventricular failure after left ventricular
assist device implantation.
Am J Cardiol
Demirozu ZT, Etheridge WB, Radovancevic R, Frazier OH. Results
of HeartMate II left ventricular assist device implantation on renal
function in patients requiring post-implant renal replacement therapy.
Heart Lung Transplant
Noor MR, Bowles C, Banner NR. Relationship between pump speed
and exercise capacity during HeartMate II left ventricular assist device
support: influence of residual left ventricular function.
Eur J Heart Fail
Raina A, Seetha Rammohan HR, Gertz ZM, Rame JE, Woo YJ,
Kirkpatrick JN. Postoperative right ventricular failure after left ventric-
ular assist device placement is predicted by preoperative echocar-
diographic structural, hemodynamic, and functional parameters.
Lund LH, Gabrielsen A, Tirén L, Hallberg A, El Karlsson K, Eriksson
MJ. Derived and displayed power consumption, flow and pulsatility
over a range of HeartMate II left ventricular assist device settings.
Soc Artif Intern Organs J
Soleimani B, Haouzi A, Manoskey A, Stephenson ER, El-Banayosy A,
Pae WE. Development of aortic insufficiency in patients supported with
continuous flow left ventricular assist devices. Development of aortic
insufficiency in patients supported with continuous flow left ventricular
Am Soc Artif Intern Organs J
Chapman CB, Allana S, Sweitzer NK, Kohmoto T, Murray M, Murray
. Effects of HeartMate II left ventricular assist device as observed
by serial echocardiography.
2013 Jan 11. doi: 10.1111/
echo.12100. [Epub ahead of print].
Mookadam F, Kendall CB, Wong RK, Kalya A, Warsame T, Arabia
. Left ventricular assist devices: physiologic assessment using
echocardiography for management and optimization.
10. Topilsky Y, Maltais S, Oh JK, Atchison FW, Perrault LP, Carrier M,
. Focused review on transthoracic echocardiographic assessment of
patients with continuous axial left ventricular assist devices.
11. Toda K, Fujita T, Domae K, Shimahara Y, Kobayashi J, Nakatani T.
Late aortic insufficiency related to poor prognosis during left ventricular
assist device support.
Ann Thorac Surg
12. Topilsky Y, Hasin T, Oh JK, Borgeson DD, Boilson BA, Schirger JA,
. Echocardiographic variables after left ventricular assist device
implantation associated with adverse outcome.
Circ Cardiovasc Imaging
13. Shah NR, Cevik C, Hernandez A, Gregoric ID, Frazier OH, Stainback
RF. Transthoracic echocardiography of the HeartWare left ventricular
J Cardiac Fail
14. Kucukaksu DS, Sener E, Undar A, Noon GP, Tasdemir O. First Turkish
experience with the Micromed DeBakey VAD.
Texas Heart Inst J
15. Pektok E, Demirozu ZT, Arat N, Yildiz O, Oklu E, Eker D,
Remote monitoring of LVAD parameters after Heart Assist 5 implanta-
16. Frazier OH, Khalil HA, Benkowski RJ, Cohn WE. Optimization of
axial-pump pressure sensitivity for continuous-flow total artificial heart.
J Heart Lung Transplant
17. Chiu WC, Girdhar G, Xenos M, Alemu Y, Soares JS, Einou S,
. Thromboresistance comparision of HeartMate II ventricular
assist device with the device thrombogenicity emulation optimized
HeartAssist V VAD.
J Biomech Eng