AGH surgeons implant totally artificial organ that can serve as bridge to transplant

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Patients in the region with a failing heart now have a new option in keeping blood pumping while awaiting a transplant.

Cardiothoracic surgeons at Allegheny General Hospital announced on Thursday that they had successfully implanted into a 62-year-old local man the newest version of a totally artificial heart.

"It's another technology available to us," Srinivas Murali, medical director of Allegheny General's Cardiovascular Institute, said about the device developed by SynCardia Systems Inc.

The total artificial heart is designed for patients who suffer from end-stage heart failure of both ventricles and qualify for a bridge to transplant.

"Even though small, it's a group we've never been able to help before," said Raymond Benza, medical director of Allegheny General's Advanced Heart Failure, Transplantation and Mechanical Circulatory Support Program.

The patient, who was not identified at a news conference Thursday, received the artificial heart on Feb. 17. He has been placed on a transplant list.

"He's done remarkably well and is recuperating in the hospital," said Stephen Bailey, Allegheny General's surgical director of cardiac transplantation and mechanical circulatory support programs. The patient "is not yet walking, but he's awake and interacting with his family."

The FDA approved the use of the SynCardia artificial heart in 2004. It took AGH cardiologists about six months for their team and support staff to get certified to implant the devices.

That opportunity came when the patient was taken to Forbes Hospital in Monroeville suffering from an acute heart attack.

Doctors gave him cardiopulmonary resuscitation for more than a half-hour, but there was nothing to be done, they said.

They placed him on a device similar to a heart-lung machine and transferred him to Allegheny General Hospital. There, cardiologists observed him for 24 hours as he remained supported by what is known as an ECMO device, named for the life-saving process of extracorporeal membrane oxygenation.

Doctors hoped to wean him from ECMO, and if that wasn't possible, to give him a device called an LVAD, which supports the function of the left ventricle, the lower-left chamber of the heart.

"We learned we needed something better," Dr. Bailey said.

Doctors made the decision to give him the artificial heart.

It's powered with air and vacuum provided by a pneumatic driver that weighs more than 400 pounds, requiring patients to remain in the hospital while on it.

But AGH is one of 30 U.S. medical centers participating in the clinical trial of SynCardia's Freedom, a 13-pound portable driver that allows patients using the artificial heart to go home while waiting for a donor heart. Twenty-three American patients have taken the portable version home.

Allegheny General's cardiology team hopes to wean the patient off the 400-pound driver and get him qualified for the trial of the portable. "He'll be in the hospital for a while," Dr. Bailey said. "It's our goal for him to go home."

Dr. Bailey also called the patient's chances of getting a heart transplant "quite good."

To implant the SynCardia heart, surgeons remove both ventricles and the four natural valves of the heart. They leave the left and right atria (upper chambers), aorta and pulmonary artery intact.

More than 950 SynCardia hearts have been implanted in patients worldwide. The longest a patient has been supported by one of the devices as a bridge to successful heart transplantation was 46 months, the manufacturer said.

First Published February 24, 2012 5:00 AM


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