LVADs Artificial Hearts
ICDs
Pacemakers
Read The Manual
Heart failure
Heart Transplant
 
 
 Updated November 29, 2005

HeartMate LVADLVAD means Left Ventricular Assist Device. An LVAD is a surgically implanted mechanical device that helps the heart pump blood. In other words, they are "heart pumps" or "heart assist devices." If both your heart's pumping chambers are failing, 2 heart pumps may be used, one for each ventricle. The last few years have been a bonanza for this kind of technology, so settle in and read all about it. Although this page deals mainly with LVADs for people with heart failure, LVADs are used in 3 groups of people


  1. People waiting for a heart transplant. Many people have such weak hearts they won't live long enough to get a donor heart. These patients get an LVAD as a "bridge to transplant" - the device stays in place until the heart transplant is ready to be done, then it is removed. Most patients in this group get an air-powered LVAD, with a power supply the size of a desk. You're stuck in the hospital with this kind of LVAD
  2. LVAD diagramPeople who have heart surgery but whose heart can't handle the load right after surgery. Doctors say these patients cannot be "weaned" from the heart-lung machine. They get an LVAD to keep them alive until their heart function returns to near-normal. This usually only takes a few days
  3. People with severe heart failure are now in an LVAD trial called REMATCH, testing LVADs as permanent implants. Half the trial's patients will get maximum drug therapy for their heart failure. The other half get a portable electric LVAD on a permanent basis. Since the implant is permanent, the patients get to live at home, although there are restrictions

LVAD diagramHow does an LVAD work? An LVAD either takes over or assists the pumping role of the left ventricle - the heart's main pumping chamber. Newer LVADs are mean to be permanent in people with severe heart failure.
LVAD battery pack     Part of the device is implanted in your heart and abdomen, and part remains outside your body. You carry the external part of the device on a belt around your waist or on a shoulder strap. Most LVADs right now have an electric pump, an electronic controller, an energy supply (usually a battery weighing about 8 pounds) and 2 tubes. One tube carries blood from your left ventricle into the device. The other tube takes blood pumped from the device into your aorta (artery) to be circulated throughout your body. Different companies attack the problem of heart assist in different ways. Here are some of the major players.


The HeartMate LVAD is made by Thoratec. It comes in 2 flavors - pneumatic (IP) and electric (VE). The air-powered version now has a portable power unit in trials that you push on a small, wheeled cart. The electric version - called the HeartMate VE (Vented Electric) - is in trials as a permanent implant in CHF patients.
Heartmate 2 LVADThe HeartMate is implanted in your abdomen. Blood goes into the device through a tube attached to your left ventricle. Once blood from the heart empties into the device, an external control system triggers pumping. A pusher plate forces a flexible diaphragm upward. This pushes the blood through an outflow tube attached to the aorta (the main artery supplying the body with blood). Valves keep blood flowing in the right direction.
     One of the big problems with LVADs has been blood "sticking" to the inside of the device and clotting, causing strokes. Making the surfaces smooth doesn't help at all, but making them textured a certain way does. Go figure.
     The HeartMate uses textured surfaces which encourage your body to deposit material on them from your blood. These blood materials actually form a biologic layer on the device's inner surfaces. This lining is a lot like the inner surfaces of your arteries and veins, and it helps prevent strokes. It's so good at this that with the HeartMate you don't have to take blood thinners to prevent strokes - just aspirin! The clot rate is 6% at most.
Heartmate 2 LVADThe HeartMate is called a "pulsatile" pump because it pumps blood in a cycle of pump/relax, pump/relax, just like your heart does. This is what gives you a "pulse." The HeartMate can pump up to 10 liters of blood per minute. This allows it to get plenty of blood to all your organs.
     After implant, you use a belt-carried controller and a pair of rechargeable batteries to power your HeartMate. This lets you be mobile for around 5 to 6 hours. The HeartMate has 2 modes: Fixed Mode causes the device to pump at a constant rate, while Auto Mode causes the device to pump more blood if you are active, and to pump less blood if you are not. This is called "rate-responsive" action.
     A separate unit charges the batteries, monitors how the system is working, and has a direct power connection for when the batteries are not in use.



So this must cost a fortune, right? Well, it ain't cheap. However, because it keeps you out of the ICU, cuts down your drug needs and reduces the amount of close monitoring by expensive medical staffers, using an LVAD can be cheaper than no LVAD. The break-even point is about 45 to 50 days after implant.
high costBoth the air-driven and electric HeartMates are FDA approved as "bridge to transplant." The electric HeartMate is in trials now as a permanent implant for people with severe heart failure - the REMATCH study.
     Medicare does cover the HeartMate system. Some insurers who might pay for an LVAD include Blue Cross/Blue Shield, Aetna, Kaiser Foundation/Kaiser Permanente, and U.S. Healthcare. Some other insurers approve LVAD use on a case by case basis.
     The HeartMate's manufacturer - like all such companies - are heavily into developing their next "generation" device. The HeartMate 2 is a high-speed rotary pump that is much smaller so it can also be implanted in children. The parts that push blood in it are magnetically driven, eliminating most moving parts. This increases the device's life span. The DeBakey LVAD uses this principle also, although it is different in many ways.


DeBakey VADMicromed is implanting the DeBakey LVAD in American patients now as a trial. This LVAD is contained completely inside the body, as is the Arrow LionHeart device. The DeBakey device is "non-pulsatile." It moves blood continuously throughout your body instead of with the pump/relax cycle of a real heart. Is this good or bad? No one knows. Personally, I wonder if continuous blood flow is a good long-term idea in a body that is meant to use a pump/relax cycle. However, the non-pulsatile devices are nearly silent, while pulsatile devices can make quite a noise with each beat.
DeBakey LVAD diagramCurrently, it takes less surgery time to implant a DeBakey VAD than a HeartMate - about 1 1/2 hours. The DeBakey device is also currently less expensive. It has only one moving part: the inducer/impeller. Studies so far suggest that this VAD will last about 5 years before needing to be replaced.
     The inducer/impeller has 6 blades with 8 magnets sealed in each blade. This inducer/impeller spins between 8,000 and 12,000 times per minute. This allows it to pump up to 10 liters of blood per minute. All parts are enclosed in a sealed titanium tube. The pump is driven by a direct current motor stator with no brushes. The titanium inlet tube attaches to the left ventricle; the outlet tube is sewn to the aorta.
     The main control unit is called the "Patient Home Support System," This charges the batteries and provides power when you're stationary for awhile. The Patient Home Support System is the size of a small cooler and weighs about 10 pounds. The controller and 2 batteries fit into a carrying case with strap, which weighs about 5 pounds. The two batteries in this carrying case give a total battery time of 6 to 8 hours per charge.



Arrow Lionheart VADThe Arrow LionHeart device was first implanted into an American on February 28, 2001. This is a "pulsatile" VAD and uses a wireless power transmitter instead of wires going through your skin. This means you actually have a battery inside your body, allowing you to be completely disconnected from your external battery pack for as long as 20 minutes. That may not seem like much, but think about it. That disconnected time lets you take a shower like a regular person! Little touches like that can really improve your quality of life.
     Once the system is implanted in a patient, no wires or tubes go through your skin at all. The system is transcutaneous - which just means "through the skin" and that's how the power is supplied - wireless - through your skin. One advantage to this is less chance of infection. Wherever a tube or wire goes through the skin, infections are likely; No tubes or wires, less risk of infection.
     The Arrow LionHeart is meant to be permanent and is made in modules so parts can be changed without replacing the whole device. Like the DeBakey VAD, the Arrow LionHeart has been in clinical trials in Europe for quite awhile, where trial regulations are looser.
Arrow Lionheart VADThe external power source is a pair of battery packs worn on a belt. These run the motor through a transformer coil worn on the outside of the chest. When the external transformer coil is placed over the implanted transformer coil, it produces electrical current. This current keeps the pump running.
     The VAD itself pumps when a metal plate pushes on a plastic blood sac, forcing the blood out of the sac. The metal plate is driven by a miniature electric motor, with a controller that increases or decreases pumping as your activity level goes up and down.
     There is no vent tube coming through your skin like with many other LVADs because a compliance chamber takes care of changes in gas volume with every beat of the pump. Air inside the compliance chamber helps in the pumping, but over time the air seeps through the synthetic wall of the chamber into the body and dissipates. The air has to be replaced once in awhile. New materials are being studied to fix this drawback.


Yikes! Okay, now the natural question popping into my head is, "What happens if this sucker stops pumping?!" Well, you keep your natural heart - unlike getting a total artificial heart - where your heart is removed and replaced. Hopefully, your heart is well rested from the LVAD's help so far, and has enough strength to keep you alive until you make it to the ER. Now however, there is a way to manually pump your heart using the LVAD if its power source fails. This will keep you going plenty long enough to get proper medical care. See www.thoratec.com/medical-professionals/heartmate_lvas.htm for lots of such information about the HeartMate.
     A few years ago I told a Blooomberg News reporter that I thought the brightest area of future treatment for CHF was heart assist devices. I see no reason to change my mind now. Obstacles still include a tendency to infection, blood clots, and the limitations of the devices themselves. However, as these obstacles are tackled at multiple manufacturers, I think LVADs will save lots of lives and improve even more.

 

LVADs

WWW Links

 Improvement With LVAD

July, 1997 - LVADs in DCM patients may improve heart function and allow later removal of the device. We report the long-term effects on heart function, auto-antibodies, and heart scarring when an LVAD allows the heart to rest.
     Seventeen class 4 CHFers with non-ischemic DCM got LVADs. All had very weak heart function with EF less than 16%, and an enlarged heart. They all tested positive for auto-antibodies. Echocardiograms, blood tests and heart biopsies were done before and after LVADs were implanted. Average time on LVAD was 230 days. Six patients died, 4 were transplanted and 2 are still on LVAD.
     Five patients had excellent recovery of heart function with EF improving to an average of 47%. They were weaned off their LVADs after 160 to 794 days and are now device-free for 51 to 592 days. Auto-antibodies gradually disappeared during LVAD use. However, 9 patients' heart function barely improved at all during LVAD use.
     Heart function can be improved nearly to normal in some patients with end-stage DCM by using an LVAD, and then eventually removing the device. The degree of heart fibrosis may indicate which patients will benefit; Auto-antibodies can be used to monitor heart cell recovery.
 
Title: Weaning from mechanical cardiac support in patients with idiopathic dilated cardiomyopathy
Author: Muller J, Wallukat G, Weng YG, Dandel M, Spiegelsberger S, Semrau S, Brandes K, Theodoridis V, Loebe M, Meyer R, Hetzer R
Source: Circulation 1997 Jul 15;96(2):542-549
Comment in: Circulation 1997 Jul 15;96(2):393-5
PMID: 9244223, UI: 97386374

 Heart Function Improves With LVAD

November, 1997 - Recently, heart recovery in CHF patients has been reported after long-term LVAD use. We studied the recovery process in some of these patients. We implanted the Heartmate LVAD in 2 heart failure patients who had been rejected for transplant. Both were class 4 and had kidney failure, and one was diabetic. We studied heart function by echo at 4, 6, and 8 weeks after implanting the LVAD.
     With the LVAD turned off, we saw increasing ability of their hearts to beat strongly, beginning as early as 4 weeks after implant and improving from then on. Tissue examination showed that heart muscle cells were no longer disintegrating.
     Heart recovery begins earlier than we thought. LVAD use leading to recovery of heart function is possible for some CHFers.
 
Title: Mechanical support in dilated cardiomyopathy: signs of early left ventricular recovery
Author: Westaby S, Jin XY, Katsumata T, Taggart DP, Coats AJ, Frazier OH
Source: Ann Thorac Surg 1997 Nov;64(5):1303-1308
PMID: 9386694, UI: 98047925

 LVADs Come Home With You

September 30, 1998 - The government has approved a pair of battery powered heart pumps for use at home instead of in the hospital. The new implanted pumps, made by Baxter and Thermo CardioSystems (TCS), let patients live at home.
     Doctors are now studying whether these pumps are a long-term alternative to heart transplant. The implanted pumps do most of the weak heart's work, increasing a patient's chances of living long enough to have a transplant.
     The pumps are now only for patients at risk of immediate death, because they can cause serious side effects. They require major surgery and can cause infections, blood clots, and strokes.
     Baxter implanted its Novacor pump in 104 patients - 78% survived long enough to get a transplant. In 35 equally sick patients who did not get an LVAD, only 37% survived to transplant. TCI compared its HeartMate to the big in-hospital pumps now used and concluded that both in-hospital and at-home versions worked equally well.
     The two pumps are very similar, but have not been directly compared so there's no way to say which pump is better for each patient. However, significantly more Novacor (by Baxter) patients did suffer a blood clot. TCI said its HeartMate implant will cost $60,000. Baxter hasn't determined a U.S. price but sells the machine in Europe for about $75,000.
 
Source: the Associated Press

 LVADs Increase Infection Risk

August 16, 1999 - Getting an LVAD is linked to T-cell death, increasing the risk of serious infection. However, "as long as we can understand the ways the immune response is being triggered, we can come up with ways to regulate it," study author Dr. Itescu said. T-cells are part of the body's immune system, which fights infection.
     One complication of using LVADs in heart failure patients is the increased risk of serious infection. Dr. Itescu found that over a 3 month period, 28% of heart failure patients who got an LVAD developed infections compared to only 3% of similar patients who were managed without an LVAD. Dr. Itescu said he is optimistic about long-term LVAD use for heart failure but, "these devices are clearly not without their risks."
 
Source: Lancet 1999;354:550-555

 LVADs Cause Immune Reactions

February, 1999 - In patients with an LVAD, it is unknown how much the device disturbs the immune system versus how much the heart failure itself affects the immune system.
     In 11 heart transplant candidates who needed LVAD support, we measured interleukin-6, T-cells, and monocytes. We compared them to 15 status II patients awaiting heart transplant on drug therapy for CHF. Measurements were taken at time of LVAD implant and 2 and 4 months later. Thirty-two healthy people served as a reference group.
     Patients with LVADs had higher C-reactive protein, leukocyte, neutrophil, and monocyte levels at all 3 follow-ups. They had lower CD3+, CD4+, and T-cell counts than drug-treated patients 2 months after LVAD implant. In comparison to healthy controls, both groups had increased inflammatory activity and weaker immune systems at all follow-ups.
     While end-stage CHFersin general showed immune system changes compared to healthy controls, patients who needed an LVAD showed more immune system reaction. This may be due to more advanced heart failure but the device itself may also be contributing to inflammation.
 
Title: Left ventricular assist system support is associated with persistent inflammation and temporary immunosuppression
Authors: Deng MC, Erren M, Tjan TD, Tamminga N, Werntze B, Zimmermann P, Weyand M, Hammel D, Schmidt C, Scheld HH
Source: Thorac Cardiovasc Surg 1999 Feb;47 Suppl 2:326-31 PMID: 10218610, UI: 99232978

 LVAD Does Not Cure Inflammation

January 17, 2002 - Heart failure patients suffer from chronic internal inflammation. Using an LVAD only relieves a small part of that inflammation. Dr. A. Clark studied 48 patients with an average age of 45 years, in class 4 CHF. Each patient had an LVAD implanted as a bridge to transplant.
     One week after LVAD implant, TNF-alpha levels fell, but by 90 days they had risen to pre-LVAD levels. Other inflammatory measures also went down, only to go back up by 90 days after device implant. In these 48 patients the one-year survival rate was 35%.
     The only predictor of survival was body mass index. In the 16 patients with a body mass index higher than 25, the one-year survival rate was 63%. In the 32 patients with a body mass index under 25, one-year survival rate was 22%.
 
Source: Eur Heart J 2001;22:2227-2230, 2275-2283

 FDA Approves Arrow LionHeart Trials

February 26, 2001 - The FDA has approved US trials of the Arrow LionHeart LVAD. "We have been approved to do a safety study of the device in 7 patients," Dr. Walter Pae, Jr. said. The device has been in clinical trials in Europe since 1999.
     The Arrow LionHeart device is unique among LVADs because it is completely contained inside the chest. Its power is delivered through an external battery pack but there are no wires. The external power pack charges the internal batteries by passing its power right through the skin by conduction - like artificial hearts.
     The device is designed as a as a permanent implant. Such a device might allow CHF patients to have a quality of life better than what is currently achieved with heart transplant, said Dr. Pae.
 
Source: Reuters Health

 LVAD Improves Life At Home

February 21, 2000 - Using an LVAD as an outpatient therapy pays off. It costs less to send patients home with an LVAD than to keep them in the hospital. Patients are also better off physically and mentally at home. Dr. David Morales reviewed the 6 year experience of 90 outpatients with a wearable LVAD manufactured by TCI.
      The device kept 44 patients alive long enough to have a heart transplant and for 2 patients to have planned removal of the device. The incidence of bleeding was 2%, of device infection 5%, of blood clot 1% and of major malfunction 2%. The researchers estimate the cost to bridge a patient to either heart transplant or device removal with this LVAD on an outpatient basis is $13,200. The cost if the patient remained in the hospital would be $165,200, and that includes only room and board.
     In these patients, 30% returned to work or school, 33% resumed sexual activity, and 44% were able to drive again. All patients were more or less independent in activities of daily living at home. Dr. Morales writes that "LVAD outpatients were shown to improve in the physical, psychologic, emotional and social aspects of their lives when discharged home and they did much better than transplant candidates at home or LVAD inpatients."
 
Source: J Thorac Cardiovasc Surg 2000;119:251-259

 Jarvik Permanent Implant In Trials

April 14, 2000 - Doctors at the Texas Heart Institute have implanted the Jarvik 2000 into the heart of a patient for the first time in the USA. Powered by batteries, the Jarvik 2000 - about the size of a wine cork - fits directly into the heart's left ventricle. The tiny turbine keeps blood flowing when the heart is too weak to do it all. The Texas Heart Institute received permission from the FDA to implant the Jarvik 2000 in a limited number of patients, the institute said.
     "We're all looking forward to it," said Dr. Patrick McCarthy, the director of the heart transplant and artificial heart pump programs at the Cleveland Clinic. "We hope it will be better tolerated than larger pumps," added McCarthy. Texas Heart Institute doctors have declined requests for interviews about the procedure.
     The Jarvik 2000 was developed by Dr. Robert Jarvik and Dr. O. H. Frazier. The official word is that the device has been implanted as a "bridge to transplant," meaning a way to buy time for a dying patient until a donor heart is available. A second device will be tested in England as a permanent implant.
     A similar device by Dr. Michael DeBakey is in trials in Europe as a bridge to transplant in 28 people. Like the Jarvik 2000, DeBakey's device is a miniature axial flow pump, but it is inserted into the aorta.
 
Source: The Houston Chronicle

 Permanent LVAD For CHF

July 21, 2000 - The first person to have the Jarvik 2000 miniature heart pump successfully implanted is back home after having a heart transplant. Lois Spiller, a 52 year old retired financial analyst, said, "I'm just real happy to be here today."
     The Jarvik 2000 LVAD was implanted in Spiller's failing heart on April 10, 2000, after FDA approval was given to begin clinical trials with the device. The device is about the size of a wine cork and fits directly into the heart's left ventricle. For now, the FDA has approved study of the pump only as a bridge to transplant.
     Two other patients with end-stage heart failure have been implanted with the device and are awaiting transplant. Another two had the device implanted on an emergency basis but both died shortly after their surgery. Spiller had the device in her heart for 79 days.
 
Source: AP

 Thoratec IVAD Goes Into Trials

February 21, 2001 - Thoratec has been given conditional approval from the FDA to begin testing its IVAD (Implantable Ventricular Assist Device). This is an implantable version of its already approved VAD.
     The company has begun securing local hospital approvals and selecting investigators for the study, which will involve about 30 patients. Investigators will follow-up implanted patients until the devices are removed. Thoratec hopes to get this IVAD on the market through an "abbreviated" approval process because the IVAD is so similar to non-implanted system.
 
Source: Reuters Health

 REMATCH Results

November 12, 2001 - Dr. Eric Rose and the REMATCH study group randomly assigned 129 end-stage CHF patients who did not qualify for transplant to get a Heartmate LVAD (68 patients) or best drug therapy (61 patients). All had class 4 CHF.
     Risk of death from any cause was 48% lower in the LVAD group than the drug group. Survival at one year was 52% in the LVAD group versus 25% in the drug group. At 2 years, it was 23% in the LVAD group versus 8% in the drug group.
     Serious adverse events in the LVAD group happened more than twice as often as in the drug group. The most common events were infection, bleeding, and device malfunction. However, QOL was much improved at one year in the LVAD group. In the LVAD group, says Dr. Rose, "Many had an adverse event who did better after that adverse event, particularly the period right after implanting the device. Only about 10% of LVAD patients had a stroke."
     Dr. Rose added, "The REMATCH results in the 22 patients under 60 years old were stunning. The 74% one-year survival brings it up almost to the performance of transplant." The researchers concluded that using an LVAD in patients with advanced heart failure improves survival and quality of life. They believe an LVAD is an acceptable alternate therapy in some CHF patients.
 
Title: Long-Term Use of a Left Ventricular Assist Device for End-Stage Heart Failure
Authors: Eric Rose, Annetine Gelijns, Alan Moskowitz, Daniel Heitjan, Lynne Stevenson, Walter Dembitsky, James Long, Deborah Ascheim, Anita Tierney, Ronald Levitan, John Watson, Nuala Ronan, Peter Shapiro, Ronald Lazar, Leslie Miller, Lopa Gupta, Howard Frazier, Patrice Desvigne-Nickens, Mehmet Oz, Victor Poirier, Paul Meier
Source: N Engl J Med 2001;345:1435-1443,1490-1493. November 15, 2001, Number 20

 Plans For Better Heartmate 3 LVAD

November, 2001 - More effective technology will be seen in the upcoming HeartMate 3. It will be a miniature centrifugal pump with a magnetically controlled impeller (an impeller is what actually moves the blood - think propellor). The Heartmate 3 will have no moving parts touching each other, reducing wear and increasing the device's life. The HeartMate 3 will be smaller than the Heartmate 2 and will not have any tubes or wires penetrating the skin.
Source: TCI

 Permanent LVAD Implant Tentatively Approved

March 5, 2002 - FDA advisers have recommended that the HeartMate LVAD be approved as a permanent implant for end-stage heart failure patients. Because the device is risky, the panel put conditions on approval to tighten up patient selection. Thoratec's HeartMate will be used in patients who will not be getting a heart transplant and will almost certainly die without some form of drastic intervention.
     In a trial of about 130 such patients, the LVAD cut deaths by 27% over drug treatment alone in the first year. Unlike the HeartMate 2 and 3, the HeartMate was not designed for long-term use, so breakdowns are more likely. The failure rate in the study was over 20%.
     Side effects also included stroke, bleeding and infections. Infections are a problem because a wire goes through the skin to connect the internal pump to a battery pack worn on a shoulder strap. The HeartMate 3 will not have this problem.
     One condition for FDA approval later this year is that all patients understand exactly what they're getting into. The FDA is not bound by this panel's suggestions but often follows them.
 
Source: AP

 Permanent LVAD Implant Approved

November 7, 2002 - The HeartMate LVAD got FDA approval Wednesday as a permanent heart assist device in the USA. A study released last year showed the HeartMate can add months to the lives of CHF patients who can't receive a transplant. Sixty-eight end-stage CHFers got the HeartMate. Half were still alive a year later, compared to 28% of another 61 patients who got standard drug therapy instead. After two years, 27% of HeartMate recipients were still alive, compared with 10% of the drug-treated group.
     The LVAD does requires major surgery to implant, and can cause life-threatening side effects. Ten percent of HeartMate recipients suffer a stroke, 41% get an infection and over 30% needed further surgery due to heavy bleeding.
 
Source: AP

 LVAD Improves Survival After Transplant

April 18, 2002 - Patients who use an LVAD as a bridge to heart transplant have better overall survival than those treated with IV inotropes. Dr. Francis Pagani says, "The reason for this is that LVAD use improves kidney function and overall physical condition before heart transplant."
     Dr. Pagani compared the survival of 104 patients who were bridged to transplant with an LVAD or with inotropic drugs. At 3 years after transplant, survival was 95% in LVAD patients compared to 65% in patients getting IV inotropes.
     Dr. Pagani concludes that, "treatment with LVAD as a bridge to heart transplant appears to yield significantly improved overall long-term survival." He adds, "As soon as pump technology gets a little bit better, LVAD may be a very viable option for long-term therapy instead of transplant."
 
Source: J Am Coll Cardiol 2002;39:1247-1257 & Reuters Health

 Ventracor LVAD Implanted

June 30, 2003 - Surgeons in Melbourne, Australia have implanted the first Ventracor VentrAssist LVAD. The procedure was done on June 28 and took 5 hours. This first implant is part of a pilot trial at The Alfred Hospital of up to 10 patients - a safety trial. It is expected that it will be about 2 to 3 months before the next device is implanted.
 
Source: Ventracor press release.

 DeBakey VAD Implanted In Teenager

October 14, 2004 - 14-year-old Travis Marcus became the second child to have a small LVAD implanted as a bridge to transplant. He had been on a heart-lung bypass machine and respirator before this to keep him alive, while being fed by IV. Now he can walk through hospital hallways, carrying a battery pack for his internal heart pump. His doctor expects Travis to get a donor heart in a month or so.
     The VAD was implanted at Arkansas Children's Hospital a month ago. Eleven pediatric hospitals in the USA will use the DeBakey VAD for children. The one-inch by 3-inch pump weighs 4 ounces. Made of titanium and plastic, it is internal except for the power pack, which is wireless. Over 240 DeBakey VADs have been implanted in adults, although it is not yet FDA-approved in the USA.
     MicroMed Technology Inc. of Houston modified the VAD and the USA government gave a humanitarian exemption for its use in children. Earlier this year, a 5-year-old Houston girl received a DeBakey VAD but she died 16 days later.
 
Source: Intelihealth, Associated Press.

 HeartMate II For A Full Year

November 19, 2004 - 19-year-old Everardo Flores has now had a HeartMate II LVAD implanted for a full year. "I felt like a brand-new person," he said after the implant. "I didn't know how sick I was." In that year, he has celebrated the birth of a daughter, addressed an audience of doctors at a national heart meeting, and is working toward his high school equivalency.
     Lores is part of a phase one study by Thoratec Corporation, which manufactures the LVAD. Twenty-five people in the USA have received a HeartMate II so far. The HeartMate II is smaller and has fewer moving parts than older LVADS. Another newer style LVAD is the MicroMed DeBakey LVAD, also in trials.
     Hopefully, an LVAD allows a patient to get stronger so that when they get a heart transplant, the transplant is less risky because their body is working better when they get it. Other organs are less likely to fail if they get strong blood flow using the LVAD while waiting for a donor heart.
     The HeartMate II is about the size of a large D-cell battery, allowing smaller people to use it, including children. However, the other equipment needed to keep it running is extensive. The pump is powered through a small wire that comes out of the stomach area. Care is required to prevent infection.
     Batteries in holsters hang from each shoulder and a patient wears a large control panel at his waist. When away from home, a 10-pound bag with extra batteries and a spare control panel must go with you. You must wake up at least once a night to change batteries. Flores says, "It gets kind of heavy after a while."
 
Source: New York Times News Service
Source: Intelihealth.

 Jarvik FlowMaker LVAD Approved in Europe

May 24, 2005 - The Jarvik 2000 FlowMaker LVAD is now approved in Europe for bridge-to-transplant and for lifetime use in CHFers. This is a very small 3 oz (90 gram) titanium device about the size of a C-cell flashlight battery. It is implanted in the the heart's left ventricle to pump blood to the descending aorta. Of course, the device itself is not the entire package - there is also a sewing cuff to fasten it to your heart (implanted), an outflow "hose" (implanted), a power cable (partially implanted), power supply and controller.
     As bridge to transplant, the LVAD is managed by a line that connects to a small battery pack/controller worn at the waist or in a small shoulder bag. For those receiving it as a permanent implant, the power connection is implanted in the skull behind the ear. This is like the system used for hearting (cochlear) implants.
     The Jarvik 2000 works best as an "assist" device in people whose hearts can still handle a decent part of the load. So far, there have not been any mechanical failures and infection rates are low. Patients have had the device implanted for as long as 5 years already. See photos at www.umm.edu/features/jarvikgallery/index.html.
 
Source: Medscape
Source: Ann Surg 237(5):631-637, 2003.


All information on this site is opinion only. All concepts, explanations, trials, and studies have been re-written in plain English and may contain errors. I am not a doctor. Use the reference information at the end of each article to search MedLine for more complete and accurate information. All original copyrights apply. No information on this page should be used by any person to affect their medical, legal, educational, social, or psychological treatment in any way. I am not a doctor. This web site and all its pages, graphics, and content copyright © 1997, 1998, 1999, 2000, 2001, 2002, 2003, 2004, 2005 Jon C.

Talk to Jon Site Index