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Barnes-Jewish Patient First in St. Louis to Receive Artificial Heart

  • November 2, 2009
  • Number of views: 4539

Barnes-Jewish Patient First in St. Louis to Receive Artificial Heart
Jason Merrill

[email protected]

ST. LOUIS – A 47-year-old man is the first patient in St. Louis to successfully receive an FDA approved total artificial heart. The device was implanted by the Washington University cardiac surgical team at Barnes-Jewish Hospital, led by Nader Moazami, MD and assisted by I-Wen Wang, MD, on October 27.

Barnes-Jewish is one of only 12 hospitals in the United States certified to implant the CardioWest™ temporary Total Artificial Heart (TAH-t) as a bridge-to-transplantation in specific heart transplant candidates.

The CardioWest™ TAH-t is an improved version of the Jarvik-7 Artificial Heart, which was first implanted in Barney Clark in 1982. The heart transplant team is the only one in the Midwest to use the artificial heart.

“This unique technology allows us to treat the most challenging group of patients who have severe dysfunction of the entire heart muscle and would not survive without full circulatory support,” says Dr. Moazami, MD, surgical director of heart transplant at Barnes-Jewish Hospital and Washington University School of Medicine.

The CardioWest™ TAH-t completely replaces the patient's diseased heart with a goal of restoring normal blood pressure and cardiac output and also facilitating recovery of end-organ function, such as the kidney and liver. As a result, patients become better candidates for transplantation. The U.S. Food and Drug Administration (FDA) approved the artificial heart for use as bridge-to-transplant in 2004 for patients at risk of imminent death from non-reversible biventricular failure.

“By replacing the heart with an artificial pump, we can revive the patients, rehabilitate them, and make them a better transplant candidate,” says Dr. Moazami. In addition to offering the CardioWest™ TAH-t, the heart transplant team at Barnes-Jewish and Washington University School of Medicine is the only group in the St. Louis area approved by the federal Medicare program to permanently implant left ventricular assist devices (LVADs) to help those suffering from advanced stage heart failure.

In 2003, the Center for Medicare and Medicaid Services began covering the HeartMate LVAD for “destination therapy.” It allowed patients too sick for transplant to permanently live on a device that sits inside the body next to a patient’s abdomen and assist the heart’s pumping function. Over 40 LVADs have been implanted so far in 2009.

“Patients are able to go home and live their daily lives without being tied to the hospital,” says Dr. Moazami of the LVAD. However, patients must still wear an external battery pack with power cables connected to the device inside the patient’s body. Conversely, the CardioWest™ device consists of two mechanical ventricles connected to the respective native atria and greater blood vessels. An air hose or drive line covered with double velour material passes from each ventricle out through the skin to a console that pulses pressurized air and monitors pump function. The device fully supports the patient’s circulatory system.

Since 1985, Washington University surgeons at Barnes-Jewish Hospital have performed more than 500 heart transplants. After 20 years, almost half of these patients are still alive. The program has gained a reputation for taking on some of the most challenging cases – patients who may have been turned down at other centers – and still achieving very strong survival rates. The program is now known as one of the leading centers in the country for post-transplant care and use of devices such as ventricular assist device as a bridge or alternative to transplant.

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