Trong thử nghiệm trận tái đấu, nhiễm trùng và cơ khí thất bại của thiết bị góp phần quan trọng để tỷ lệ sống thấp 2 năm 23%. Các thiết bị employeddthe HeartMate XVEdrequires một đường qua da lớn, có thể trở thành một ống dẫn bị nhiễm trùng do vi khuẩn và nấm. Suy dinh dưỡng đã được xác định ở những bệnh nhân | SYMPTOMATIC RELIEF 261 In the REMATCH trial infection and mechanical failure of the device contributed importantly to the low 2-year survival rate of 23 . The device employed the HeartMate XVE requires a large percutaneous line which can become a conduit for bacterial and fungal infection. Malnutrition was identified in these patients as a predisposing factor to infection and other complications. Factors contributing to postoperative malnutrition include early satiety nausea or both from the bulk of the implanted device chronic inflammation associated with HF and the device and severe and often-underdiagnosed preoperative debilitation 15 . Because these pumps are large a substantial pump pocket must be formed around them and the blood that collects in this pump pocket can be a culture medium for bacteria. The axial flow devices on the other hand are much smaller than conventional LVADs. Furthermore the Jarvik 2000 is implanted within the left ventricle eliminating the need for a pump pocket altogether. One study has shown that the Jarvik 2000 is associated with a lower infection rate than a conventional LVAD 7 . Additionally the 26 patients in the authors previously published clinical study experienced no significant device-related infections 10 . Because infections can reduce QOL by interfering with daily activities requiring patients to take additional medications or necessitating a return to the hospital the reduced infection rate associated with the Jarvik 2000 may enable the device to enhance QOL to a greater extent than conventional LVADs. Mechanical failure of the LVAD was the second most frequent cause of death in the REMATCH trial s device group. The findings of inflow-valve failure and late erosions of the outflow graft resulting from kinking have already led to modifications in the device s design. Malfunction of the mechanical parts such as rupture of the lining motor failure and wear on the bearings also limits the durability of the device. Device .
