Emory University Hospital is the first hospital in Georgia to offer a non-surgical device that helps patients survive severe heart attacks, while also making those needing a heart transplant healthy enough to be placed on a transplant waiting list.
The TandemHeart PTVA System is designed to help patients survive life-saving, high-risk procedures and other cardiac interventions without undergoing major surgery. The device restores blood circulation through a cardiac catheterization procedure in as little as 30 minutes. The resulting increase in blood flow--up to five liters per minute--helps to save vital organs and gives damaged hearts a chance to heal when patients experience acute, life-threatening heart conditions.
According to John Douglas, MD, professor of medicine in the Emory University School of Medicine and director of the Interventional Cardiology and Cardiac Catheterization Laboratory at Emory University Hospital, TandemHeart is a percutaneous (through the skin) ventricular assist device designed for rapid insertion through femoral artery access. The minimally invasive system is designed to help critically ill patients withstand necessary catheter-based procedures, such as balloon angioplasty and stent placement, and may also allow the heart ample time to strengthen until a donor heart becomes available if required, becoming, in essence, a life-preserving bridge-to-transplant.
"Traditional ventricular assist devices require major surgery, which involves cutting the chest, exposing the heart, and inserting the device," explained Dr. Douglas. "Very often, a patient is simply too ill to undergo such a serious procedure. This device can be inserted in the catheter lab without doing surgery, which is the greatest benefit to the patient. Any time you can save an already critically ill patient from undergoing an unnecessary major surgery, you increase the odds of recovery."
TandemHeart is attached to the bloodstream and the heart using thin tubes that doctors insert into the body though tiny cuts in the thigh, which are then guided carefully through the femoral artery and into the heart. One tube is gently poked through the wall that divides the two sides of the heart. These tiny tubes, called cannulae, are then attached to a small pump outside the body that pushes blood forward at a precise rate.
The device then takes over for the damaged or left side of the heart, which is responsible for receiving oxygen-rich blood from the lungs and then pumping it out to the body. For that reason, TandemHeart is considered a ventricular assist device (VAD). Because the device is attached externally, it's called a percutaneous VAD.
According to Vasilis Babaliaros, assistant professor of medicine in the Emory University School of Medicine, TandemHeart will most often be used in patients who require bypass, heart valve or open-heart surgery, those requiring very short-term bridging before receiving a longer-term VAD, and patients undergoing high-risk angioplasty or stenting to help relax the heart during the procedure.
"TandemHeart provides us with a new, reliable short-term option for patients with serious cardiac illnesses. While it will not be suitable for each of our patients, it will provide many very sick individuals with necessary support until we can stabilize them and proceed with the next viable treatment," said Dr. Babaliaros.
"This device can be used to provide more valuable time for our patients, and sustain them to some level of recovery, so they may be able to tolerate a more invasive procedure such as the implantation of another long-term ventricular assist device, organ transplant, or a definitive heart valve replacement."