Facing certain death, with a heart working at only 23 percent, Maria was the first person on the West Coast to receive a new device for mechanical support of her failing heart. A left ventricular assist device (LVAD) takes over for the left ventricle when the heart can no longer pump blood through the body.
With more than 30 years of experience in advanced cardiac care, Sharp Memorial Hospital has pioneered work on mechanical hearts, including numerous clinical trials. Recently, the hospital became the first on the West Coast to implant the investigational HeartMate III™ pump as part of a nationwide clinical trial.
The LVAD was created as a “bridge” technology for patients awaiting a match for heart transplant. Are patients like Maria now able to live out their lives with an LVAD instead of a transplant?
Yes. When patients are selected for LVAD implantation, they are placed into one of two categories: bridge to transplant (BTT) or destination therapy. Maria was a BTT candidate, and one day we hope that she receives a heart transplant, but many patients — the majority at Sharp —are implanted as destination therapy, and will live out the remainder of their lives with an LVAD.
A mechanical heart seems like something out of science-fiction. How does the technology work?
There is a lot of science behind an LVAD, but it definitely isn't fiction. Without getting into too much detail, the pump is implanted into the left lower chamber (left ventricle) of the heart. It consists of a cannula (a metal tube) that takes blood out of the heart, passes it through a motor and returns blood back into the aorta, or main blood vessel of the body, through another cannula. The motor itself connects to a driveline, or a fancy power cord, which extends outside of the patient’s abdomen. This is hooked up to a controller and battery pack, which makes sure the pump is programmed to the right speed and always powered to work. In the latest HeartMate, the rotor is suspended magnetically. This eliminates friction — reducing wear and tear on the rotor, and minimizing injury to blood cells.
Is this option right for everyone with severe heart disease?
Definitely not. LVADs are a complicated and life-changing therapy. It is only intended for patients with end-stage failure of the left ventricle. It is not for people with isolated coronary artery disease, valve disease or arrhythmias. Our patients go through a stringent selection process, which includes a comprehensive medical (including cardiac and non-cardiac issues) and psychosocial evaluation before they are accepted for implantation.
How did Sharp become a leading center for this technology?
Sharp has been a leader in this technology since I was a toddler. When the heart transplant program began in 1985, Sharp made a commitment to providing excellent cardiac care to our community in San Diego. The program has grown, but still includes four original team members. With their leadership, the program has evolved with the field, and Sharp has always stayed on the cutting-edge of technology, participating in all of the key clinical trials throughout the years with regard to mechanical support. It is the commitment of the entire team to provide excellent patient care that allows our organization to be a leader.
Learn more about Maria’s “battery-powered heart” in this follow-up to her original story.