Tandem Heart.....

TennRN2004 · Jul 30, 2006

Looks like a pretty nifty piece of equipment Trans. We only use abiomeds at my hospital, and those are only 1 every year or two, we've only had one since I've been in my unit. Do you use these where you work? Do you primarily use them as a bridge to transplant? I would guess any VAD would function essentially the same, but I know the class we had at work (of course taught by the abiomed rep) stated that I think like 98% of hospitals use

abiomeds.

CardioTrans, BSN, RN · Jul 30, 2006

We have started using them in the past 2 months.

We are mainly using them as a temporary intervention for pts with an MI, or Cardiogenic shock, for short term LV assistance. It is placed in the cath lab, and helps decrease LV wall tension, decrease O2 consumption and increases CO. It is also being used for post stents to temporarily help before a CABG.

We had a lady last week that was flown in from out of state that had had an IABP for 14 days. We placed the tandem heart on Thursday and her CO was 2.0 prior to the tandem. She had the tandem overnight, and on Friday they pulled it. Her CO had increased to 3.5. After it was pulled her CO never dropped below 3.0.

We still use the larger LVADs as a bridge to transplant.

TennRN2004 · Jul 30, 2006

I'll ask our head surgeon about these. We have exactly some of the pts you describe that could benefit from these it sounds like. We all cringe when you hear of one come in as a redo with a crappy EF, b/c they inevitably head down the CRRT, trach, chronic care trail. I hate it for the pts and family b/c I don't think they understand it's not going to be as easy a go round as the first time was. Is your facility doing a comparison of before and after using them to have data regarding their outcomes? It would be very interesting to see those numbers, but it sounds like just the one patient alone got loads of benefit from it.

augigi, CNS · Aug 2, 2006

They have done a lot of study into Tandem Hearts at Pittsburgh, where I was able to work for a while. They are easy to insert, easy to remove, and provide kind of "turbo-charged IABP" level support. They are temporary and low level support. I think the manufacturer claims max flow of 5lpm, but I have not seen that much support provided, more in between an IABP and say a VAD such as Levitronix.

Overall, a great "emergency" support that is very easy to use while a decision is made for longer-term support (future options like transplant-eligibility, consent, social situation, insurance etc).

I would be very sceptical to hear that 98% of hospitals use Abiomeds!!! The new AB5000 ventricle are pretty good for converting patients on the old-style BVS5000 device for longer term, but there are much better VADs for longterm support.

augigi, CNS · Aug 2, 2006

By the way, I should mention that I work for a VAD company (although not Levotronix, Abiomed, or Tandem Heart).

TennRN2004 · Aug 5, 2006

They have done a lot of study into Tandem Hearts at Pittsburgh, where I was able to work for a while. They are easy to insert, easy to remove, and provide kind of "turbo-charged IABP" level support. They are temporary and low level support. I think the manufacturer claims max flow of 5lpm, but I have not seen that much support provided, more in between an IABP and say a VAD such as Levitronix.
Overall, a great "emergency" support that is very easy to use while a decision is made for longer-term support (future options like transplant-eligibility, consent, social situation, insurance etc).
I would be very sceptical to hear that 98% of hospitals use Abiomeds!!! The new AB5000 ventricle are pretty good for converting patients on the old-style BVS5000 device for longer term, but there are much better VADs for longterm support.

Notice I said that number came from our class taught by the ABIOMED REPRESENTATIVE, so of course the data is probably a little skewed, which was why I pointed out that information came from the rep. And, I may be misstating just slightly (but I did say "I think" on that percentage), I have the forms she handed out somewhere, but I know for a fact they reported the percentage was in the 90's.

augigi, CNS · Aug 6, 2006

I don't disbelieve you! As a "rep" for a device company I find it a bit sad that you assume the company is skewing the numbers though!!

I do think that a lot of units have the old Abiomed BVS5000 on the shelf but no longer use it due to too many hematologic complications, but it is there as an emergency measure (and you can use bypass cannula so it's easy to connect).

TennRN2004 · Aug 8, 2006

I don't disbelieve you! As a "rep" for a device company I find it a bit sad that you assume the company is skewing the numbers though!!
quote]
"Skewed" may be a bit too strong of a word. What I meant was that data can easily be made to look one way or another, depending on who is interpreting the numbers. I am not saying I believe or don't believe what we were told by the abiomed representative, but for me to 100% believe it, if I cared that much, I would invesigate such information for myself. I think most people would agree that it is wise to be at least a little bit skeptical of information (until you check it out yourself) coming from someone who has a vested interest in any type of product, including medical supplies/products.

hoag · Aug 23, 2006

We have just purchased one for our unit and need to write a policy. Any info you could send my way? The inservice was short but the equipment seems relatively easy to use. We plan on using it in the cath lab for high risk and also if there's problems coming off bypass and the IABP is not enough. Thanks

augigi, CNS · Aug 28, 2006

The company should provide you with training and policy material, alternatively contact a hospital that uses it and ask for a copy of theirs. I'd give you one, but I am no longer at that hospital :)