Tandem Heart used for treatment of the most severe forms of heart failure – left ventricular support

Overview

Tandem Heart is a relatively newly developed device for active short-term hemodynamic support (percutaneous ventricular assist device, pVAD).

The device, or “pump”, is linked to blood circulation in the left ventricle following a transseptal puncture and introduction of a 21F venous suction cannula. The blood is guided into the centrifugal pump proper and returns into the circulation through a 15–17F arterial cannula via the femoral artery. The main indication for VAD is cardiogenic shock, particularly in the absence of an adequate hemodynamic response to IABC. Physiologically, left heart preload is reduced by 30-50%, reducing its workload and improving contractility. The main contraindication is right-sided heart failure.

Compared to IABC, recovery of haemodynamic parameters, especially drop in filling pressure and increase of heart output, is more rapid and marked after VAD introduction.

In 2005, we used Tandem Heart in two patients at the cardiology department of our hospital. The first was a 51-year-old male suffering cardiogenic shock during a large anterior wall MI. The second patient was a 63-year-old male with severe post-infarction left ventricular dysfunction with an ICD (Implanted Cardioverter Defibrillator), who experienced severe heart failure during an arrhythmic storm. The VAD was used to secure haemodynamics during electroanatomic mapping and radiofrequency ablation of ventricular tachycardia.

Key words:
Tandem Heart, heart assist device, heart failure, cardiogenic shock, myocardial infarction