Patients too sick to survive heart surgery can now be treated with a new device at Barnes-Jewish Hospital and Washington University School of Medicine designed for those with the sickest of hearts.
The Tandem Heart is a small left ventricular assist device (LVAD) for patients in extreme heart failure.
According to the American Heart Association, almost 5 million Americans live with heart failure with more than 550,000 cases diagnosed each year. Sometimes when patients in heart failure arrive at the hospital, they are so ill that any sort of surgery or therapy could be fatal. That''s where the Tandem Heart comes in.
"The device is for the most critically ill patients," explains Dr. John Lasala, director of interventional cardiology at Barnes-Jewish Hospital and Washington University School of Medicine.
With conventional LVADs such as HeartMate and Navacor, surgeons attach the device to the heart''s left ventricle. The LVAD then sits over the abdomen inside the skin and assists with heart function. The patient then waits for a new heart via transplant, allows the heart to return to health or actually lives on the device indefinitely.
Tandem Heart is a temporary device used in the catheterization lab by Dr. Lasala with assistance from Dr. Nader Moazami, surgical director of heart transplant at Barnes-Jewish Hospital and Washington University School of Medicine. Tubes from the device are inserted percutaneously through a large vein in the leg while the device itself straps around the patient''s right leg. Oxygen-rich blood is withdrawn from the left atrium of the heart and returned through the large artery.
The device was used for the first time in St. Louis in April on a 75-year old man with artery blockage. "His heart was so weak he would not have survived a surgical procedure," says Dr. Moazami.
By placing the patient on the Tandem Heart, Drs. Lasala and Moazami were able to stabilize his heart and insert stents into the blocked arteries.
"In this particular case we did see the pumping function of the heart improved after two or three days," says Dr. Lasala. The patient''s heart function improved so dramatically, the Tandem Heart was removed in three days and the patient returned home in only seven days.
The Tandem Heart assumes about 85 percent of the heart''s pumping function and has been approved for temporary cardiac backup, not long-term use.