Inflammatory Response after Implantation of a Left Ventricular Assist Device: Comparison between the Axial Flow MicroMed DeBakey VAD and the Pulsatile Novacor Device

• Published in: ASAIO journal (1992) Vol. 47; no. 3; pp. 272 - 274
• Main Authors: Loebe, Matthias, Koster, Andreas, Sänger, Stefan, Potapov, Evgenij V, Kuppe, Hermann, Noon, George P, Hetzer, Roland
• Format: Journal Article
• Language: English
• Published: Philadelphia, PA Lippincott Williams & Wilkins, Inc 01-05-2001; Hagerstown, MD Lippincott
• Subjects: Adult; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Blood Coagulation - immunology; Complement Activation; Complement C3a - metabolism; Complement C5a - metabolism; Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care; Female; Heart Failure - immunology; Heart Failure - surgery; Heart Failure - therapy; Heart-Assist Devices - adverse effects; Humans; Intensive care medicine; Interleukin-6 - metabolism; Leukocyte Elastase - metabolism; Male; Medical sciences; Middle Aged; Prosthesis Implantation; Pulsatile Flow; Tumor Necrosis Factor-alpha - metabolism; Human; Intensive cardiocirculatory care; Implanted material; Iatrogenic; Prognosis; Device; Cardiocirculatory support; Complication; Inflammation; Comparative study; Left ventricle
• ISSN: 1058-2916; 1538-943X
• DOI: 10.1097/00002480-200105000-00023

The implantation of a ventricular assist device (VAD) is associated with a stimulation of the inflammatory system. We compared changes in the inflammatory response after implantation of a pulsatile Novacor left (L) VAD and the axial flow MicroMed DeBakey VAD. Six consecutive patients after implantation of a Novacor LVAD (NC) and six patients after implantation of a MicroMed DeBakey VAD (MD) were included in the investigation. Patients received LVADs for medically non treatable end-stage heart failure. Tumor necrosis factor alpha (TNF), C3a, C5a, interleukin 6 (IL-6), and neutrophil elastase were measured twice a week over a period of 3 months after implantation of the device. All tests were performed with an enzyme-linked immunosorbent assay. There was no significant difference in the clinical course of the two groups. All inflammatory parameters were elevated in both groups during the entire period of the investigation. There was no difference in TNF, polynuclear leukocyte elastase, or C3a levels between the two groups; however, IL-6 (NC23.6 ± 37.6 pg/ml vs. MD63 ± 114 pg/ml, p < 0.001) and C5a (NC708 ± 352 μg/L vs. MD1,745 ± 1,305 μg/L, p < 0.001) were increased significantly more in patients following implantation of the axial flow MicroMed DeBakey VAD. Compared with the pulsatile Novacor device, the implantation of the axial flow MicroMed DeBakey LVAD seems to be associated with an increased stimulation of one part of the inflammatory system. Further investigations are necessary for evaluation of the pathophysiologic mechanism and clinical implications of these findings.