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New Hope for Patients Waiting for Heart Transplant

Posted - Aug. 30, 2004 at 8:33 a.m.



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Dr. Kim Mulvihill reporting Each year nearly 300-thousand Americans die from heart failure, many while waiting for a heart transplant.

But it looks like there's new hope for the sickest of these patients.

This hope comes in the form of an investigational device that may improve the odds for patients.

The findings suggest two surgeries may actually be better than one.

It's been 22 years since Seattle dentist Barney Clark got the world's first artificial heart. Since then, the design has changed, but the goal remains the same: take the place of a failing heart, pump blood through the body, and stay alive.

In most cases, the left side of the heart fails, and doctors use the l-vad-- or left ventricular assist device -- as a permanent replacement.

However, cardiologist Dr. Dale Renlund says that's not always enough.

What happens if both sides of the heart fail?

Dr. Dale Renlund/ LDS Hospital: "You need really two pumps. You need both a right and a left ventricular assist and that's available in something like this total artificial heart."

The experimental device, called the Cardiowest, is not a permanent solution, but a bridge that helps critically ill patients who are waiting for a new heart.

Now new research shows this high tech pump saves lives. As reported in the New England Journal of Medicine, the device not only improved the odds of surviving until the time of a transplant, but it also improved the odds of survival after the transplant.

"This also doesn't squander these valuable donor organs that are the basis of all heart transplantation. If you take and transplant into a very high risk situation where the likelihood of survival is poor, you are in essence squandering a large portion of those hearts. Whereas if you make the recipient, the candidate better, and improve the chances of a successful transplant, you have squandered fewer donor hearts."

And that's particularly important given the shortage of donor hearts.

The lack of donors is significant in that right now we have 3,800 people listed and waiting for heart transplantation, and only 2,000 will be transplanted during this coming year.

As to how much of an impact the Cardiowest can make: there was an 86 per cent transplant success rate in patients who got the device.

The success rate for those who went straight to transplant was about 50 per cent.

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