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Abiomed bvs 5000 bi-ventricular support system
Abiomed Cardiovascular, Inc. BVS 5000 Bi-Ventricular Support System
The BVS 5000 is a biventricular support system manufactured by ABIOMED Cardiovascular, Inc, (Danvers, MA). The system is capable of univentricular or biventricular support. It is a pulsatile pump, is fully automatic, and has a dual-chamber design. There are three components to the system: the pneumatic drive console, a dual-chamber blood pump, and atrial and arterial cannulas.
The blood pumps are extracorporeal and sit at the bedside on an intravenous pole. Filling can be altered by adjusting the level of the pump on the intravenous pole relative to the patient (Fig 1Go). The cannulas exit the patient in a subcostal manner.
The pump is a dual-chamber pump contained in a hard polycarbonate housing. The upper chamber is a passive, gravity-filled reservoir and the lower chamber is the pumping chamber. The upper and lower chambers are separated by an inflow valve and then the lower chamber is separated from the arterial circulation with an outflow valve that ensures unidirectional flow of blood. As the pumping chamber is filled with blood, all of the surrounding air is returned to the console. This is sensed by the console, which immediately sends compressed air back to the pumping chamber, compressing the bladder and ejecting blood to the patient. Unidirectional flow of blood is ensured by the inflow and outflow valve. The valves are polyurethane trileaflet valves.
There were some design goals with the BVS 5000. These goals were to be safe, simple, and effective. The safety of the pump is due to its design: a dual-chamber pump with a built-in reservoir. There is no vacuum as blood drains merely by gravity.
There are visual and audible alarms as well as multiple backup systems. The experience with the device has demonstrated no significant hemolysis. Postcardiotomy patients usually return from the operating room with very high plasma-free hemoglobin levels due to the prolonged period on cardiopulmonary bypass. As support is initiated and continued, the plasma free hemoglobin level has dropped much less than 10 mg/dL.
The BVS 5000 is very simple to operate. It has an automated control system with on and off operation. It automatically adjusts for changes in the patient preload and afterload, and it requires minimal operator intervention. It has been easier for the nurses to manage than the intraaortic balloon and has required no added personnel for device management.
The BVS has been shown to be very effective for circulatory support. The dual-chamber, two-valve design mimics the natural heart. It fully decompresses the ventricle, allowing it to rest. It provides pulsatile flow to the major organs. The pulse pressures exhibited are physiologic. During support the device will allow withdrawal of inotropes to rest the heart.
Currently more than 500 patients have been supported with the BVS. The premarket approval application study demonstrated a 55% wean rate with 29% discharge [1]. On November 20, 1992, the Food and Drug Administration granted premarket approval of the BVS, making it the only approved postcardiotomy ventricular assist device in the United States.
