Experience with the Berlin Heart Assist Device

A New Method of Mechanical Circulatory Support with an Implantable Multichamber Pump System (IMPS): Presentation and First Experimental Results

This paper presents a new cardiac support device for left ventricular failure which consists of two inflatable bellows positioned dorsally and ventrally to the left ventricle. The implantable multichamber pump system (IMPS) is driven by a pneumatic pump system and controlled by a microcomputer using ECG-trigger and pacemaker modules. It was implanted via thoracotomy in 8 pigs. The circulatory parameters were measured in the animals on β-blockers, with cardiac failure and in ventricular fibrillation with an activated (IMPS on) and deactivated (IMPS off) system.

IMPS significantly increased the left ventricular pressure (LVPsys IMPS off: 63 ∓ 6 mmHg vs IMPS on: 96 ∓ 8 mmHg) and the blood pressure in the common carotid artery (Bpca' IMPS off: 69/38 mmHg vs IMPS on: 95/40 mmHg).

The IMPS proved to be highly efficient in the therapy of animals with acute cardiac failure and in ventricular fibrillation in the experimental model. Apart from its efficiency the advantages with this system are the ease of handling and its high biocompatibility due to the lack of contact with circulating blood.

Biventricular mechanical replacement

The role of biventricular mechanical support (assist or replacement) is important for the management of severe biventricular cardiac failure. One only has to look at the role of cardiac transplantation to realize the benefit of a natural therapy to end-stage heart disease. Although the technology today is not that different from the technology that existed a decade ago (ie, BioMedicus, BVS 5000, Thoratec, CardioWest), the application of it and the experience gained by it have allowed surgeons to improve the chances of a positive outcome. In terms of new technologies for biventricular mechanical support, the totally implantable versions of a VAD (eg, Thoratec IVAD) or the totally implantable TAH (eg, AbioCor) are promising technologies that add to the spectrum of devices as destination therapy or alternatives to transplantation. And lastly, the role of the Berlin Heart as a tool for the management of biventricular failure in pediatric patients may be realized in the United States in the near future. In conclusion, the treatment of biventricular failure (acute or chronic) with assist or replacement technologies has gained widespread acceptance in the medical and surgical communities. It is now time to use these technologies wisely in an effort to treat the worldwide epidemic of congestive heart failure.