New Technologies

The ROTOFLOW VAD

(Maquet)

This is the second post regarding VAD technology. These posts are not meant to promote or recommend any particular system over another system.  That is  not what this forum is about.

These devices are out there and being used by our peers, so I ask exactly that from you- an honest peer response about your clinical assessment and experiences with these systems.  We are looking seriously at upgrading our VAD capability.

I was asked by one of our surgeons about the ROTOFLOW.  Having not seen it personally, I wanted to solicit opinions of individuals that have had the opportunity to either trial it- or have seen a demonstration of this device.  Any and all comments would be appreciated, please leave them in the comments section.

We are also looking at the CentriMag VAD (read previous new-technologies) and would welcome any opinions or comparisons regarding the differences between the two pumps.   There are some comments on the previous review (click to read previous comments) .

Realizing that there is a cost difference between the two systems, I would like to avoid prejudice here, based on cost alone.  Are there any performance or clinical aspects that separates one from the other?

What I have found out so far …

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  • The pump head is unique, simple, and sophisticated. In fact, it’s the only one with metal shaft and seal eliminated; this pump features a peg-top, one-point sapphire bearing, which lowers friction substantially. Its spiral housing ensures an optimized flow ratio with no stagnant zones. The centrifugal pump’s minimal priming volume of 32 ml considerably reduces hemodilution. (Product Literature)
  • The ROTAFLOW Console operates independently as stand-alone with its own battery back-up and power supply.

Stand-Alone Features:

  • Integrated flow and bubble sensors in drive unit
  • LPM mode for convenient flow-controlled pumping
  • Low-level operation
  • Integrated battery back-up of 90 min
  • Large four-digit alphanumeric displays for flow and speed

ROTAFLOW Drive Unit

Click me ...

Other

Coupling magnetic
Speed 0 to 5000 RPM
Pressure max. 750 mmHg
Flow meter ultrasonic
Bubble sensor ultrasonic
Pump stop air bubbles > 5 mm (0.065 cm3)
Motor brushless DC
Voltage +24V

The ROTAFLOW Centrifugal Pump

Click me ...

What I haven’t found out yet …

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The most important thing …

Your thoughts on the matter  🙂

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If you haven’t taken it yet…

Plz don’t forget the

Survey on Wet Circuits

Click Here …

12 thoughts on “New Technologies

  1. I recently attended an ECMO training program and got to use the rotoflow. Quite frankly I thought it was over-engineered and somewhat difficult to use. I have the c-mag at my hospital and find it highly reliable, and easy to use. There are some who say that medicare reimbursement is much higher with the c-mag. I do not have the info on that yet. My biggest reason for advocating the c-mag is it’s ease of use. The ICU nurses are going to be monitoring it so…make it simple!

    1. Dude thanks for the reply.

      VADS aren’t something I want to give up to nurses (personally). I think we are by far the best safety net when it comes to VAD management-

      Just my opinion-

      Frank

  2. We just went through this debate and analysis a couple of months ago.
    The head are similar, but the CMag is totally levatated and bearingless. The Rotaflow has a small saphire bearing the basically keeps the impeller centered.

    Both pumps will work for ECMO and run w/o problems for 30+ days. Reimbusement for there use w/ECMO or VAD is the same as the reimbusement does not state specific pump technology, just DRG-3 for ECMO or DRG-215 for VAD. The CMag is approvaed for use in RVAD aaplication for 30 days.

    The difference is in price of the heads ($10K vs. $200). But the Cmag is still the cheapest VAD compared to AB5000 ($40K), Impella 2.5 ($27K) or 5.0 ($32K).

    The other difference is on the consoles. I agree with John’s post. The Rotaflow is very engineeric (not a word) but you get what I mean. It has a lot of menus (some embedded within others), small display, flow needs zeroed, is a heavier console. It is fine for a perfusionist to operate and watch, but probably not a nurse or tech. The Cmag, on the other hand, is easy to operate and geared for nurses. It has a RPm lock, flow limits, does not need to zeroed, and the console is light.

    Since we don’t know are volume of ECMO and VADS that we will be doing, we went with 3 CMags. If the ECMO volume is there in a year or tow, we may purchase a Rotaflow for that purpose as they are less expensive. Some centers are also using the COb revolution for ECMO and others are using the Carmeda Coated Biomedicus with no problems running 2-3 wks, although that has not been my experience with the non-coated biomedicus in a VAD application back ion the days. Maybe the Biomedicus lasts longer in a VV ECMO (lower pressures) application.

    1. Wow Jeff-

      That was pretty direct and concise.

      The console aspect is something to be considered- but is it a comfort level thing the more you use it?

      In my opinion, zeroing is a minor effort right? Any limitations with tubing thickness and flow probe readings?

    2. Jeff,

      We have struggled justifying the added the huge expense of adding the Cmag. This struggle is compounded when our sense is these are equivalent pump systems. We use the Rotaflow in all ECMO patients 0 – 68 (so far…).

      Another consideration, the Cmag has no emergency hand crank. It has a backup of some sort (I have forgotten exactly the design). Either device should have a backup in house!

      We are primarily a congenital heart center and use the Rotaflow for cardiac ECMO on babies. We have used the Rotaflow in ~ 75-100 kids and it works great.

      I am interested in the Levotronix “Pedi MAG”. That device has become available in the US in the last year.

      Anyway my thoughts…

      Brad

  3. Check your reimbursement. If you are going to use it primarily as a VAD, then buy a CentriMag because you can get reimbursed through insurance. If your use is primarily for ECMO, CPS, Left heart bypass, etc. then use the RotaFlow. We originally used the CentriMag exclusively for our ECMO patients. Since early last year we began using the RotaFlow in approximately 70% of our cases (39 ECMOs for 2010, 18 for 2011) and have not seen any real differences in performance. The RotaFlow is heavier for transport but that is the only negative.

    Hope that this helps.

  4. Rotoflow. I was informed by a colleague that there was a run-away on a ECMO unit in late January in the USA. I believe it is very rare. It was purchased via a distributor and not directly from the company.

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