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Heart Failure

UVA Implants New Device for End-Stage Patients

Doctors at the University of Virginia Health System’s heart transplant center are now implanting the latest left ventricular assist device (LVAD), the Heartmate II®, in patients with end-stage cardiomyopathy as a bridge to transplant.

“With this device, they’re staying alive and moving into the next phase and getting transplanted with a new heart,” says Jim Bergin, MD, medical director of UVA’s heart transplant program.

Because the Heartmate II is smaller than earlier LVADs, implantation is easier for patients to tolerate. “The operation does not take as long and is less of a physiologic insult because we don’t have to make as big an incision,” says John Kern, MD, chief of heart transplant surgery at UVA. “Patients wake up, they get off the breathing machine quicker, and in a couple of days they’re eating and they just feel good.”

Hospital stays for device implantation last an average of two to three weeks. Before discharge, patients and their families are fully educated by UVA clinicians about the care and operation of the LVAD device. The LVAD is powered by an external battery unit connected to the patient through a small driveline, a semi-permanent incision in the patient’s right side. Most patients use a battery-pack vest during the day and plug the device into a power outlet before they go to bed.

Because the device is rotary instead of pulsatile, it is relatively quiet and patients with the device do not have a pulse.

“Patients have a blood pressure, it’s just a continuous steady flow of blood rather than a pumping flow,” Bergin says.

“Early on, the feeling among physicians was that not having a pulsatile blood pressure would not be good for other organs such as the kidneys,” Kern adds. “But now we’re finding out that Heartmate II patients are doing extremely well with respect to other end-organ function and living several years with this device.”

The Heartmate II has also expanded LVAD treatment to heart failure patients who were too small to tolerate earlier devices. “It does open the door for us to treat more patients with heart failure,” Kern says. “Previously, the most commonly used LVAD was a fairly big device, so for some women or a smaller person, there was simply no room.” However, the Heartmate II is too large for small children.

To refer a heart failure patient for LVAD treatment, call UVA Physician Direct at 800.552.3723.