Surgeons at Emory University Hospital recently implanted Georgia's first 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 six-hour procedure was performed at Emory University Hospital in February. A ventricular assist device is a battery-operated mechanical pump that helps a weakened heart pump blood throughout the body. It is most commonly used as a bridge to transplant for those whose medical therapy has failed and who are hospitalized with end-stage heart failure. More recently, the VAD is providing an alternative to transplant. VADs allow a near normal quality of life, with most patients returning home with their families while they wait for a donor heart to become available.
According to David Vega, MD, associate professor of cardiothoracic surgery in the Emory University School of Medicine, the patient suffered from cardiomyopathy--a deterioration of the heart muscle--and received the VAD as a means of assisting the failing heart.
"More recently, surgeons have been implanting VADs as destination therapy, which is permanent therapy for heart failure," said Dr. Vega. "This is the first device used as destination therapy in the state of Georgia--which means it will likely stay with a patient indefinitely because he or she is either ineligible for a heart transplant, or simply does not wish to have one for any number of reasons."
With a VAD as destination therapy, patients are able to resume many basic activities that were precluded by their chronic heart failure. Many patients suffering from cardiomyopathy are too weak to even walk a few steps from one end of a room to another.
The patient received a device known as the HeartMate XVE, designed to assist the heart's left ventricle, which is responsible for pumping oxygen-rich blood from the lungs throughout the body. The central component of the HeartMate is the blood pump, which is implanted just below the diaphragm in the abdomen. It is attached between the natural heart and the aorta (the main artery that feeds blood to the entire body), allowing natural circulation while providing all of the energy necessary to propel blood throughout the body.
Dr. Vega said that while the VADs are designed to last approximately two to three years, patients who are not eligible for transplant after that time may receive a new device, which is designed to improve the quality of life in patients.
"This device offers 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," Vega said. "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. This device may be a viable option for many of those patients--allowing them to resume a much more normal lifestyle and improved quality of living."
According to the United Network for Organ Sharing there are currently 3,018 Americans--70 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. ###