Heart device gives new hope to advanced heart failure patients

Wednesday, June 13, 2007

SCOTTSDALE, Ariz. - A 73-year-old Mesa man whose heart had been functioning at only 20 percent for the past several years is the first in Arizona to be implanted with a lightweight heart pump that will keep his heart beating at nearly full capacity and result in improved quality of life.

The patient was discharged from Mayo Clinic Hospital on Monday, June 11, noting that he felt "great" and boasting about having trained for 20 minutes on an exercise bike while wearing what he calls his "second heart." The pump, called a left ventricular assist device (LVAD), was implanted (alongside his own heart) on May 15 by surgeons at Mayo Clinic. The device is intended to be used for "destination therapy," meaning that the patient — who otherwise would risk serious health consequences resulting from advanced-stage heart failure — can go home and resume many of his normal activities.

Advanced-stage heart failure occurs when the weakened heart can no longer pump sufficient blood to the body's organs. Standard treatment for heart failure includes lifestyle modifications and medications to help eliminate excess fluid from the body. When symptoms become life-threatening, a heart transplant is considered. In the case of the Mesa patient, a transplant was not an option.

The LVAD, often used as a "bridge-to-transplant" until a heart becomes available, is now being used for "destination therapy."

Destination therapy means that the device provides permanent long-term support for the patient who, for medical reasons, is unable to undergo a transplant. The device does not replace the human heart, but instead is implanted alongside the natural heart, taking over the pumping mechanism of the left ventricle. The motion of the pump propels blood into the aorta and the rest of the body, pumping blood up to 10 liters per minute - the full output of a healthy beating heart. A power pack remains outside the body that is recharged at night.

Importantly, because the device is small, quiet and easy to maintain, the patient can go home and resume activity. Before leaving the hospital, the patient and his family members were provided education as to how to operate the device. The patient must demonstrate independence with self-care, management of the device and what to do in an emergency. His training exercises incorporated a trip to a local shopping mall, a night out at a restaurant and an afternoon at the movies - all under the watchful eye of Mayo Clinic staff and his family to gauge his stamina. The patient reported that his pumping device was "quiet enough that no one was bothered at the movie theater" during a showing of Oceans 13 on Sunday, June 10. Mayo Clinic in Arizona has performed 22 heart transplants since the program started in late 2005, and continues to treat and diagnose heart failure. Mayo is an approved destination therapy center for a clinical trial that uses the pumping device, formally called the HeartMate II, manufactured by the Thoratec Corp., Pleasanton, Calif., to determine the effectiveness of the left ventricular assist system for patients with advanced-stage heart failure who are not candidates for cardiac transplantation. Principal investigator for the HeartMate II trial at Mayo Clinic is Francisco Arabia, M.D., chair of Cardiothoracic Surgery and director of the Heart Transplant Program. Mayo Clinic is the only medical center in Arizona to use the HeartMate II device for destination therapy.

Nearly 5 million people in the U.S. suffer from heart failure.

Mayo Clinic is the first and largest integrated, not-for-profit group practice in the world. As a leading academic medical center in the Southwest, Mayo Clinic focuses on providing specialty and surgical care in more than 65 disciplines at its outpatient facility in north Scottsdale and at Mayo Clinic Hospital. The 208-licensed bed hospital is located at 56th Street and Mayo Boulevard (north of Bell Road) in northeast Phoenix, and provides inpatient care to support the medical and surgical specialties of the clinic, which is located at 134th Street and Shea Boulevard in Scottsdale.

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