Mechanical heart breakthrough
Published: November 2, 2006
Mechanical ‘artificial hearts’ could remove the need for heart transplantation, by returning severely failing hearts to their normal function, new research indicates.
The mechanical devices, known as left ventricular assist devices (LVADs), are currently used in patients with very severe heart failure while they await transplantation.
However a new study has shown that using an LVAD combined with certain drug therapies can shrink the enlarged heart and enable it to function normally once the LVAD is removed.
Researchers from Imperial College London (ICL) gave the full combination therapy to 15 severely ill patients, 11 of whom recovered. Of these, 88% were still free of heart disease five years later. Furthermore, their quality of life was measured as being nearly normal.
“Donor heart transplant has for many years been the gold standard in the treatment of those with severe heart failure. It has proven greatly successful but is not without its shortcomings, particularly the shortage of donor hearts and the risk of organ rejection”, explained lead researcher, Dr Emma Birks.
She emphasised that this therapy has the potential to ease the pressure on heart transplant waiting lists, while also offering patients ‘a better alternative to a donor heart - their own, healthy heart’.
The researchers said they were impressed by the ‘dramatic, sustained improvement’ in the condition of the severely ill patients who underwent this combined therapy. The improvement observed ‘was far greater than what has been reported to date for any other therapy in patients with severe but less advanced forms of heart failure’.
“The study also highlights the fact that ‘end stage’ heart failure can be reversed and that the heart has the capacity to regenerate itself”, commented Prof Magdi Yacoub of ICL.
LVADs work by being connected to the left ventricle of the heart, either directly or by a tube. They remove oxygen rich blood from the left ventricle and take it to a mechanical pump. This pump then pumps the oxygen rich blood into another tube which is connected to the aorta. Once blood is in the aorta, it can be transported to the rest of the body.
The researchers are now hoping to start a larger trial of this therapy soon.
Details of these findings are published in the New England Journal of Medicine.
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