Posts Tagged ‘VAD’

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.

Mechanical Man

November 17, 2009

Frank had a problem.

Frank had a stroke, and then the doctors diagnosed him with Dilated Cardiomyopathy. That is not a Good Thing to have, as the heart muscle has become enlarged and weakened. Frank was in heart failure, and at the moment, he was not long for this world.

So doctors at the Texas Children’s Hospital placed Frank on the heart transplant list. And to help him survive until the transplant, they placed a Ventricular Assist Device (VAD) inside his body. The VAD will literally help his heart function until a donor heart can be found. But Frank is different – he’s the very first pediatric patient to receive a VAD and be able to leave the hospital!

In the bad old days before VADs (which wasn’t that long ago) it was a race – the time it took to find a suitable donor heart verses the time it took for the patients original heart to finally just give out. And it was a high stakes race, too: if the patient lost this race, they lost their life. And too many patients were losing.

But a VAD can help a weak heart keep going, and give it a chance to win the race.