In previous posts we’ve discussed how LVAD technology can serve as destination therapy for end-stage heart failure, or as a solution for transplant patients awaiting an available donor. Today we’ll examine the latest cutting-edge LVAD technology available through our program at Emory University Hospital.
The Heartmate II is a smaller continuous flow LVAD that uses an internal motor to pump blood continuously into the ascending aorta. It provides up to 10 liters of cardiac ouput per minute, and due to its smaller size, it has a larger potential patient than previous generation LVADs.
The device is designed to provide greater mechanical reliability than previously available devices because it contains only one moving part—the internal rotor.
Our Emory VAD destination program has implanted over 25 Heartmate II devices to date.
More recently, Heartware International (Framingham, MA) introduced the HeartWare LVAD system. This device uses a centrifugal pump to provide up to 10 liters of cardiac output per minute. The device is implanted above the diaphragm, directly adjacent to the heart, resulting in minimized surgery and recovery times.
The HeartWare LVAD is similar to the HeartMate II in that it contains only one moving part: the internal impeller. In addition, it has no mechanical bearings or points of contact between the impeller and the pump housing, which lowers the risk of device failure and other complications.
Emory University Hospital is one of approximately 30 registered ADVANCE trial sites for testing the safety and efficacy of the HeartWare LVAD. The trial is an integral step towards obtaining FDA approval for the bridge-to-transplant indication. (The HeartWare LVAD is already approved in Europe as a bridge to cardiac transplantation.)
In December of 2009, a study published in the New England Journal of Medicine revealed that continuous-flow LVADs significantly increase the chance of stroke-free survival and decrease the probability of device failure at the 2-year mark, as compared with a pulsatile-flow LVAD in patients with end-stage heart failure who were ineligible for transplantation.
It also revealed that patients who received the continuous flow device had an actuarial survival rate at two years of 58%, as compared to 24% for patients who received the pulsatile-flow device.
At Emory, we demonstrate our dedication to the advancement of heart failure therapy not only by staying on the forefront of technology, but also by treating our patients as family.
Do you have questions about our LVAD technology? If so, please feel free to let me know in the comments.
About J. David Vega, MD:
In 1999, Dr. Vega implanted Georgia’s first dual pump ventricular assist device (VAD) to serve as a bridge to heart transplantation, a procedure that initiated Emory’s ongoing national position at the forefront of the use of mechanical circulatory assist devices. In 2006, he implanted the state’s first VAD as a form of destination therapy for individuals who are ineligible for or are unwilling to undergo a heart transplant, and in 2007 he implanted an even smaller VAD for the same purpose that featured an automatic speed control mode designed to regulate pumping activity based on different levels of patient or cardiac activity.