What is Tandem Heart®
To support cardiac failure or to bridge the time till permanent solution found (cardiac surgery, heart transplant etc) various mechanical circulatory support systems have been used. Intraaortic balloon pump (IABP) is the most widely used measure but it is limited in its funtion due to support it provides and in its relatively shorter duration of use desired.
The Tandem Heart® Percutaneous Ventricular Assist Device (pVAD)™ system uses a transseptal cannula that allows direct unloading of the left heart at blood flow rates sufficient to sustain patients.
In TandemHeart a percutaneous catheter inserted at the right femoral vein, advanced upto right atrium, and under flouroscopy literally a hole is made in the interatrial septum (in the fossa ovalis). Next an arterial catheter inserted percutaneously into the right femoral artery (or two arterial catheters into both femoral arteries) and then advanced into the lower abdominal aorta. Catheters made connected to a centrifugal pump. Heparin is used continuously through the lubrication system of the device, adjusting the activated clotting time (maintained at 200 seconds).
The Tandem Heart has a low blood surface contact area, resulting in reduced potential for hemolysis and thromboemboli.
Data suggests it to be a promising technology and may become a regular feature in coronary care units. In references below, we are providing results from well done studies and bedside work.
References: click to get abstracts/articles
1. Reversal of Cardiogenic Shock by Percutaneous Left Atrial-to-Femoral Arterial Bypass Assistance - (Circulation. 2001;104:2917.)
2. Clinical Experience with the TandemHeart® Percutaneous Ventricular Assist Device - Tex Heart Inst J. 2006; 33(2): 111–115.
3. Temporary assist device for postcardiotomy cardiac failure - Ann Thorac Surg 2004;77:1431-1433
4. Left ventricular assist devices as permanent heart failure therapy: the price of progress.- Ann Surg. 2003 Oct;238(4):577-83; discussion 583-5
5. Percutaneous left ventricular assist device: "TandemHeart" for high-risk coronary intervention. - Catheter Cardiovasc Interv. 2005 Jul;65(3):346-52.
