Posts Tagged ‘LVAD’

No more heart transplants?

July 13, 2010

Will heart transplants one day be a thing of the past?

I think the answer is yes – one day. Not today, and certainly not tomorrow. But there are a lot of options being worked on that hopefully one day will help patients avoid a heart transplant. One of these we have discussed before: The Ventricular Assist Device, or VAD. The VAD is a small pump that is surgically implanted into the body and connects the ventricle to the Aorta. Technically, they can assist either ventricle, but the majority of them are connected to the Left Ventricle, the name “Left Ventricle Assistance Device” and the acronym LVAD are sometime used to discuss any variety of the pumps.

The LVAD was originally thought of as a temporary device to be used to assist a heart until a transplant organ became available, a “bridge to transplant” option. But the units have improved so much that today they are also considered as a permanent implant – “Destination Therapy” that will allow the patient to resume his or her life. With that viewpoint in mind, two important tests have recently begun.

HeartWare International recently won approval from the Food and Drug Administration (FDA) to test their LVAD system as a Destination Therapy device. HeartWare has plans to select 450 patients at 50 U.S. hospitals for the study. Patients must be in “end stage heart failure who have not responded to standard medical management and who are ineligible for cardiac transplantation.” Every patient enrolled in the study will receive an LVAD. Two thirds of them will receive HeartWare’s system, while the rest receive any other FDA-approved LVAD. The study is expected to last at least two years.

Meanwhile, World Heart Corporation is testing its new LVAD, the Levacor VAD. The Levacor VAD unit is being tested as a bridge to transplant only right now, but it is a pretty amazing little machine. The Impeller (a rotor inside the unit; the part that actually pushes the blood through) doesn’t touch anything – it is suspended in place by magnets above and below it. It turns smoother, and since it doesn’t rub against another part it should never wear out. And it is small, too – the unit is about the size of a hockey puck.

The drawback is that both LVADs require battery packs that are outside the body. Unlike pacemakers, no one has been able to implant a LVAD battery unit in the body yet. But I think that is coming, though I can’t predict when.

Five CHD Questions: What?

May 10, 2010

What is the long term outlook for a child born with a  Congenital Heart Defect (CHD)?

It varies. A child born with a simple Artrial Septal Defect (ASD) or Ventricular Septal Defect (VSD) may have the defect close spontaneously as they grow. Although their lifespan may well be normal these children should be monitored by a Cardiologist at least once a year and the majority of their lifetime medical needs can be satisfied by the general medical community.

At the other end of the spectrum, there is no long-term data available for children who have Hypoplastic Left Heart Syndrome ( HLHS). The Norwood Procedure – the three surgery repair for HLHS –  was developed in the late 1970’s and early 1980’s, and Infant Heart Transplantation only became available in the mid-1980’s. The oldest HLHS survivors are in their twenties and thirties, and there is no good data yet on how these hearts are going to react to a lifetime of wear and tear.

Many recent developments could conceivably extend the lifetime of a patient with a weak heart. The Left Ventricular Assist Device (LVAD) is a small pump that is surgically implanted in the body and helps the heart to function. Most draw power from an outside source and require the owner to carry a small bag at all times, but at least one new model has no outside connections at all. It uses magnets to provide the energy needed to keep the heart pumping.

LVADs are mainly used as a “bridge to transplant” to keep a heart going until a suitable donor heart can be found, but there are other options being explored that do not involve a heart transplant – and may not even involve surgery.

One of the most promising is the insertion of replacement heart valves by Catheter. Medtronic’s valve replacement system recently entered clinical trails in the United States. Using Stem Cells to repair the heart are also an option that is being explored.

I think the future is bright for CHD survivors – a future which not only involves fewer surgical procedures but gives us an increase in quality of life and in length of life.

Pump up the ventricle!

March 12, 2010

I’ve received a press release from my friends at the Broken Hearts of the Big Bend concerning new heart pumps – better known as Ventricular Assist Devices (VADs) – being developed at the University of Maryland School of Medicine. These VADs are pretty special – they are just the right size for children! (Make sure that you page down to the bottom of the page and see just how small these devices really are!)

The National Heart, Lung, and Blood Institute (NHLBI) has signed a contract with Maryland to begin preclinical testing of the new devices. Preclinical testing occurs before the new instrument is ever used – it’s a test of systems and a safety study. And you may know one of the VAD developers: Dr. Robert Jarvick, who invented the Jarvick-7 artificial heart.

Ventricular Assist Devices (usually attached to the Left Ventricle and sometimes called LVADs) are small, self-contained pumps that can be surgically attached to a heart and help it pump blood. With the workload reduced, a weak heart can function longer and increase the odds of lasting until a heart transplant becomes available. Under the right circumstances the heart can rest and regain some function.

Teen trades machine for real heart!

February 22, 2010

NOTE: New posts may be light this week, as I am off to Atlanta to see my Adult Congenital Cardiologist. Don’t worry – this is strictly routine; the appointment was made months ago. I’m not expecting any nasty surprises.

Adventures of a Funky Heart! took note of Francesco “Frank” De Santiago back in November: If you remember, he was the young man who received a Left Ventricular Assist Device (LVAD) at Texas Children’s Hospital. What was so unusual about Frank was that he was the first Pediatric patient to be able to leave the hospital after receiving the LVAD.

Frank had to return to Texas Children’s last month…after they called him and told him that a heart was available! And on January 29, the LVAD was shut down, Frank’s old heart was removed, and another one took its place.

It was a little more complicated than that, I am sure!

The unusual part of the story was not that the LVAD worked, but that it worked so well that Frank’s general health actually improved while on the unit! According to his doctors, this made the surgery easier and should ease Frank’s recovery.