Case reportsGastrointestinal bleeding from arteriovenous malformations in patients supported by the Jarvik 2000 axial-flow left ventricular assist device
Section snippets
Jarvik 2000 left ventricular assist device
The Jarvik 2000 is an electrically powered, axial-flow LVAD. The pump is small, about the size of a D-cell battery, and is placed within the left ventricle. Its outflow graft extends from the left ventricular apex to the descending thoracic aorta. A power cable containing electric wires leads from the pump through the chest wall to the right upper quadrant of the abdomen, where the cable is externalized and connected to an analog controller. The pump is powered by lithium ion or lead acid
Presentation, history, and treatment
A 60-year-old man with a history of coronary artery disease, coronary artery bypass surgery in 1985, and implantation of an automatic internal cardiac defibrillator in 1998 presented with chest pain. On admission, he was found to have renal insufficiency and pulmonary edema. He had no history of GI bleeding. Catheterization revealed ischemic cardiomyopathy, and he was placed on the cardiac transplantation waiting list. Despite treatment with continuous intravenous inotropes and diuretics, the
Discussion
Mechanical circulatory support with an implantable ventricular assist device is applied routinely in patients needing temporary circulatory assistance while awaiting cardiac transplantation.4, 5, 6 Less frequently, a ventricular assist device is used to support patients with acute heart failure until myocardial function improves7 or to provide permanent support to patients who have end-stage heart failure, are not candidates for heart transplantation, and have no hope for improvement in
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