Surgeons at Emory University Hospital recently implanted Georgia's first HeartMate II ventricular assist device (VAD) as a form of destination therapy (in place of a donor transplant) for individuals who are not eligible for, or unwilling to undergo, a heart transplant.
The four-hour procedure to implant the device was performed on 44-year-old Debbie Hall of Savannah, who has suffered from congestive heart failure. Hall underwent the surgery for the experimental device as part of a clinical trial at Emory comparing the benefits and effectiveness of two different types of ventricular assist devices.
According to David Vega, MD, associate professor of cardiothoracic surgery, Emory University School of Medicine, Hall suffered from cardiomyopathy - a deterioration of the heart muscle. She received the device as a means of assisting the failing heart. Hall has a very high antibody count, and it is very likely her body would reject a donor organ. Because of this, she currently is unable to be listed on a heart transplant list. The LVAD, however, will allow her to experience a much better quality of life.
"Ventricular assist devices offer new hope and a much greater quality of life for individuals who are not transplant candidates, patients who do not want a transplant or for people who may be transplant eligible in the future," says Dr. Vega.
"There are approximately five million Americans who suffer from congestive heart failure, with another half million diagnosed each year. Many of these people are limited by the severity of their heart failure, yet are not able to be transplanted for one of many reasons," add Dr. Vega. "These devices may be a viable option for many patients like Debbie, allowing them to resume a much more normal lifestyle and improved quality of living."
Hall was implanted with the Thoratec Corporation-developed HeartMate II, an implantable LVAS (left ventricular assist system) consisting of a rotary blood pump that is designed to provide long-term support. The device weighs approximately 12 ounces and is approximately 1.5 inches in diameter and 2.5 inches long.
The HeartMate II provides blood flow through the circulatory system on a continual basis, and is smaller and easier to implant than "pulsatile" devices. A unique feature of the device is its automatic speed control mode that is designed to regulate pumping activity based on different levels of patient or cardiac activity. Other devices in clinical evaluation must be manually adjusted. Another appealing aspect of the device is its very small size. The new axial flow device is considerably lighter - about one pound compared to the nearly five-pound HeartMate XVE. In addition, it is smaller in size, which makes it possible to implant the HeartMate II in smaller patients, particularly women whose bodies could not accommodate the larger HeartMate XVE model.
According to Hall, who is married with two young children, the opportunity to be implanted at Emory with the VAD has already made a tremendous difference in her life.
"Before this surgery, I couldn't even walk from one end of my living room to the other without becoming tired and winded," says Hall. "With very few options available, my physician in Savannah referred me to Emory where I learned about the clinical trial testing the two different devices.
"Of course, I was a little nervous because you're not told which device you might receive, but I knew I would be in good hands either way," Hall continues. "I'm glad I got this device because as small as it is, I hardly notice it's in me, but I already feel like a totally different person now. Hopefully one day I'll be able to receive a heart transplant, but this device will help me to live a much happier and healthier life."
According to the United Network for Organ Sharing (UNOS) there are more than 2,700 Americans - 88 in Georgia - who are currently awaiting a heart transplant. Regardless of the number of donor hearts available, many patients are not candidates for a heart transplant for a variety of reasons including cancer, personal and religious beliefs, blood clotting problems, and other debilitating health conditions.
Hall represents the second patient at Emory to have received a ventricular assist device as a form of destination therapy. In February 2006, Dr. Vega and his team successfully implanted a HeartMate XVE device in a patient from the Atlanta area.