Heart transplantation is often considered to be the only way to help patients with severe heart failure. Due to donated heart supply being insufficient to provide all those with the disease with organs to transplant, special heart pumps are used as a temporary solution. However, it appears that using the device as a tool for recovery can be an option and help avoid transplantation.Heart transplantation is often considered to be the only way to help patients with severe heart failure. Due to donated heart supply being insufficient to provide all those with the disease with organs to transplant, special heart pumps are used as a temporary solution. However, it appears that using the device as a tool for recovery can be an option and help avoid transplantation.
What is the device in question?Left ventricular assist devices, which are often abbreviated as LVAD, are a means of improving heart function in people diagnosed with heart failure stage called severe, i.e. the disease end stage. These mechanical pumps help supply tissues with oxygen and nutrients by helping push blood. They are used in patients who need heart transplantation but are still waiting for a donated heart. Such pumps are battery-operated and considered only a temporary solution that can help a person wait until there is an organ ready to be transplanted. However, a research carried out by a team of investigators from Newcastle University revealed that the pumps can be used as a means of treatment aimed at helping a patient recover.
Significant improvementPreviously regarded only as bridge-to-transplant devices, LVADs, as stated in the study mentioned above, can be considered bridge-to-recovery. Of course, recovery is not guaranteed, but some patients do recover, and the extent to which they do it seems to be impressive: the researchers say some patients have heart function improved significantly, so it can be compared to that of people who have never had such a disease. There were 58 male patients participating in the project. They had heart fitness level assessed by taking a treadmill test with a special mask designed to help monitor its user’s oxygen utilization. The test also enabled the researchers to monitor the volunteers’ heart pumping capability. Their results were compared with those of ninety-seven men who had no diagnosed heart problems. Of these 58 men, sixteen had an LVAD installed and taken out as a result of recovery; 24 men were waiting for an opportunity to have the heart transplanted, and 18 volunteers were with LVAD. The average period of using a LVAD made up 396 days (though the range turned out to be wide: from twenty-two to 638 days). When the researchers assessed the heart function of the group of patients who had their devices removed, they found that the heart function improved to such an extent that it was equal to the result of healthy men of the same age in 38% cases. The next stage of the study on which the investigators are working is identifying markers that could help determine whether a patient would respond well to LVAD and whether the device can be removed. For some unknown reason, only some patients have their heart function improved with the help of the device, and when it is achieved, the LVAD can be taken out. Of course, not all patients can afford to have it removed, since the device reduces heart failure symptoms, such as fatigue and feeling short of breath, and it is necessary to make sure device removal will not lead to heart failure and symptom aggravation.
Expensive approachHowever, it must be noted that using LVAD can turn out to be very expensive, as the device cost makes up about 80,000 pounds. It is even less affordable than a transplant operation, which costs around 69,000 pounds. Perhaps, the method of identifying people who are more likely to benefit from LVAD installation can help determine what treatment strategy should be used. That it why further research is needed, investigators say.
Left Ventricular Assist Device as a Bridge to Recovery for Patients With Advanced Heart Failure – Sciencedirect.com
Left Ventricular Assist Device (LVAD) – Stanfordhealthcare.org