For years, patients on the heart transplant list faced an uncertain future of waiting by the phone for a donor heart. Unfortunately, many patients could not survive that wait. Technology is changing that.
Surgeons now use pumps called ventricular assist devices – or VADs for short – in almost half of heart transplant cases. These devices help a failing heart pump blood throughout the body.
Greg Ewald, MD, is medical director of heart transplant at Barnes-Jewish Hospital and Washington University School of Medicine. He oversees one of the nation''s oldest heart transplant programs, celebrating its 20th anniversary this month. In that time, he says VADs have saved countless lives.
"In the past we would have had to put patients on a cocktail of intravenous medicines and hope they got a donor call before they died of their heart failure," says Dr. Ewald. "Now we can actually intervene in those patients, put in a device and support those patients until they can get safely transplanted."
VADs are surgically attached to the heart''s left ventricle. The device then sits over the abdomen inside the skin. It then assists with heart function as the patient waits for a new heart via transplant.
"Now probably about half of our patients who get transplants get transplants off a mechanical assist device, so they really have revolutionized the care we provide right up to the point of transplant," says Dr. Ewald.
The new generation of the device is called HeartMate II. Dr. Ewald and his colleagues are using the device in clinical trials for eligible patients. The size of a D-cell battery, Dr. Ewald says devices like this will only improve.
"It may be that the next five or ten years, we''ll have some patients who are best suited for a heart transplant but maybe many of these patients might get a device that could stay in for five, ten years or longer," says Dr. Ewald.
Many too sick for transplant are now able to live with a VAD permanently. For those who do get a new heart, Dr. Ewald says survival rates continue to improve in part because of these devices.
Dr. Ewald and his team will celebrate the 20th anniversary of the heart transplant program on December 7. Transplant recipients from around the country will be in attendance.