Our group is responsible for the technical management of clinical applications of mechanical assist devices in our Department of Cardiothoracic Surgery. For clinical routine, Biomedicus rotary pumps, Thoratec membrane VADS and Novacor electromagnetic implantable systems are used. In these issues, we are currently working to adapt our organization together with the perfusionists of our department to the increasing workload under the aspects of the new Austrian perfusionists law. During the years of implementation of these devices to routine, and now ongoing with devices of the next generation as e.g. implanted rotary pumps, we have introduced several new types of devices to clinical use, beginning with the Vienna Artificial Heart in the Eighties, to the Novacor portable system for home patients, nowadays working with the Micromed axial flow pump and the Arrow Lionheart permanent implantable system (currently in preparation). Concomitant studies have been performed on patient management, system handling, and blood compatibility issues (see e.g. Emboli Detection)

In a clinical study, finished in April 2001, the MicroMed-DeBakey VAD was implanted in eleven patients with endstage heart disease. After recovery, regular ergometer training was performed, with loads adapted to the patients condition. Procedures for patient observation under outdoor conditions and a blood pressure measuring device for low pulse pressure conditions were developed. Improvement of physical condition was achieved in 8 patients. Beginning as the first group worldwide discharging patients with rotary pumps in December 1999, hitherto 3 patients could be discharged from hospital during support.

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Contact Persons:  Heinrich Schima

                               Ernst Wollner, MD

                               Georg Wieselthaler, MD

Cooperating Institutions:  Involved clinical Departments at the AKH Vienna

                                           Rehabilitation Center Felbring, Lower Austria

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References:

Holzer M, Behringer W, Janata A, Bayegan K, Schima H, Deckert Z, Losert U, Laggner AN, Sterz F. Extracorporeal venovenous cooling for induction of mild hypothermia in
human-sized swine. Crit Care Med. 2005 Jun;33(6):1346-50.

Thalmann M, Schima H, Wieselthaler G, Wolner E.
Physiology of continuous blood flow in recipients of rotary cardiac assist devices.
J Heart Lung Transplant. 2005 Mar;24(3):237-45. Review.

Kolodjaschna J, Berisha F, Lung S, Schima H, Polska E, Schmetterer L.
Comparison of the autoregulatory mechanisms between middle cerebral artery and ophthalmic artery after thigh cuff deflation in healthy subjects.
Invest Ophthalmol Vis Sci. 2005 Feb;46(2):636-40.

Schima H, Reindl C, Stoiber M, Rothy W, Wieselthaler G.
Emergency reinforcement of cracked paracorporeal blood pumps.
ASAIO J. 2004 Nov-Dec;50(6):621-3.

Bonaros N, Mueller MR, Salat A, Schima H, Roethy W, Kocher AA, Wolner E, Wieselthaler GM.
Extensive coagulation monitoring in patients after implantation of the MicroMed Debakey continuous flow axial pump.
ASAIO J. 2004 Sep-Oct;50(5):424-31.

Schima H, Boehm H, Huber L, Schmallegger H, Vollkron M, Hiesmayr M, Noisser R, Wieselthaler G.
Automatic system for noninvasive blood pressure determination in rotary pump recipients.
Artif Organs. 2004 May;28(5):451-7.

Wieselthaler GM, Schima H, Wolner E.
Special considerations on the implantation technique for the MicroMed-DeBakey ventricular assist device axial pump. Ann Thorac Surg. 2003 Dec;76(6):2109-11.

Wieselthaler G, Schima H et al: First experience with outpatient care of patients with implanted axial flow pumps. Artif Organs 2001.

Wieselthaler GM, Schima H, Lassnigg AM, Dworschak M, Pacher R, Grimm M, Wolner E.
Lessons learned from the first clinical implants of the DeBakey ventricular assist device axial pump: a single center report.
Ann Thorac Surg. 2001 Mar;71(3 Suppl):S139-43; discussion S144-6.

Schima, H., G. Wieselthaler, and E. Wolner. Mechanische Herzunterstützungssysteme: an der Schnittstelle zwischen Entwicklung und Anwendung. Biomed.Technik 45: 17-18, 2000.

Wieselthaler, G., H. Schima, M. Hiesmayr, R. Pacher, G. Laufer, G. P. Noon, M. DeBakey, and E. Wolner.
First clinical experiences with the DeBakey VAD continuous-axial-flow pump for bridge to Transplantation. Circ. 101: 356-359, 2000.

Wieselthaler GM, Schima H, Lassnigg A, Pacher R, Ovsenk T, Laufer G, Noon GP, DeBakey ME, Wolner E: Die DeBakey VAD-Axialpumpe: Erste klinische Erfahrungen mit einer neuen Generation von implnatierbaren, nonpusatilen Blutpumpen als Langzeitüberbrückung bis zur Transplantation. Wien Klin Wochenschr 1999 (111/16): 629-35.

Salat A, Murabito M, Böhm D, et al. Monitoring platelet function in patients on novacor. The Japanese Journal of Artificial Organs 1997;26:91

Wieselthaler G, Schima H, Laufer G, et al. Experience with long-term novacor bridge to transplant outpatients. Artif Organs 1997;21:509

Laufer G, Wieselthaler G, Mallinger R, et al. Langzeiterfahrungen mit dem Novacor-Linksventrikelersatz als Überbrückung zur Herztransplantation. Acta Chir.Austriaca 1996;126:22

Moritz A, Rokitansky A, Trubel W, et al. Timing for implantation and transplantation in mechanical bridge to transplantation. Int.J.Artif.Org. 1991;14-5:269-275

Schima H, Trubel W, Coraim F, et al. Control of the total artificial heart:New aspects in human versus animal experience. Artif.Organs 1989;Vol13,Nr6:545-552