heart surgery Archives - Amazing Health Advances

Alternatives to Heart Transplant? You Have Options

The AHA! Team — Wed, 02 Jul 2025 05:53:37 +0000

Morgan deBlecourt via Duke Health – “The good news is there are new therapies coming out every day,” said Dr. DeVore. “We can help find the option that’s right for you.” Heart transplantation can be a life-saving treatment for severe heart failure, but it’s a serious operation that requires a lifelong commitment. As a result, a heart transplant is not the best option for everyone. Fortunately, there are alternatives. “There are new therapies coming out every day,” said Adam DeVore, MD, a Duke transplant cardiologist and heart failure specialist. These new therapies can improve or help take over the heart’s function and prolong life. What Does A Heart Transplant Require? Most people who are eligible for a heart transplant have significant heart failure — a chronic condition in which your heart has trouble pumping blood — or another severe type of heart disease that could lead to death within one year. You may not be eligible for heart transplantation if you are over 70 years old or have other major health problems. Taking care of your new heart after transplant is a lifelong effort. For this reason, a heart transplant requires certain commitments, including abstaining from tobacco and illegal substances and limiting alcohol, attending frequent follow-up appointments, and taking anti-rejection and other medications. People who get a heart transplant need a strong support network, not only to help with recovery after the transplant surgery itself, but also to help coordinate appointments and long-term medications. If you aren’t eligible or if now is not the right time for heart transplantation, one of several alternatives may fit your needs. Ventricular Assist Devices Implantable left ventricular assist devices (also called VADs or LVADs) are mechanical pumps that help your heart supply blood to the rest of the body. They can extend a person’s life for years, either as they await transplant or as a definitive therapy in itself. LVADs have internal and external components. The pump is inserted into the heart during surgery. It takes blood from the left ventricle, the largest chamber of the heart that is most often weakened in people with heart failure, and pumps it directly into the aorta toward the rest of the body. The pump is connected to a controller outside of your body by a thin cord that exits through a small incision in the abdomen. Battery packs attach to the controller to power the device. Together the controller and battery packs weigh about five pounds. Living with a VAD takes some getting used to. You’ll need to always have a reliable power source available. You’ll also need to keep an eye out for infection. And although you can shower, you won’t be able to swim or take a bath, since the device can’t be submerged. Smaller LVADs Although LVADs are often used as a “bridge” to heart transplantation (meaning it supports the rest of your body while you wait for a heart transplant), advances in technology have made LVADs smaller, more portable, and more viable as a final treatment; doctors sometimes refer to this as “destination therapy.” Depending on the severity of heart failure, most people with an LVAD are able to get back to living life pretty close to normal. “Duke has been a pioneer in LVAD therapy. We have constantly worked to understand how to best care for these patients as the pumps have become more durable, smaller, and easier to implant, which all results in making it easier to have a normal life. We’re continuing to push the envelope from a technological perspective as well as a best-practice perspective,” said Duke advanced heart failure specialist and transplant cardiologist Stu Russell, MD. Artificial Heart Duke recently became the second center in the world to successfully implant a new form of mechanical heart pump known as the BiVACOR Total Artificial Heart (TAH). For people with heart failure of both the left and right sides of the heart, this device provides complete blood circulation for the entire body. Currently, the BiVACOR total artificial heart is only available as a temporary stabilizing option for people awaiting heart transplant surgery. However, pumps like these may also eventually serve as a permanent solution, similar to current LVAD treatments. Other Surgical Options for Heart Failure According to Dr. Adam DeVore, “heart failure” is an umbrella term for several heart conditions that lead to the heart failing. Depending on the underlying cause of your heart failure, surgery may be an option. For example, heart failure caused by coronary artery disease may benefit from coronary artery bypass graft (CABG) surgery. It reroutes your heart’s blood flow around a blocked, damaged, or narrowed blood vessel. Damaged or diseased heart valves can be treated with valve surgery to improve the heart’s ability to move blood properly. Ultimately, these operations may not cure your heart disease, and you might still need an LVAD or heart transplant later. Heart Failure Medical Management Whether you have a transplant, get an LVAD, or undergo a different kind of heart surgery, you’ll still need to make lifestyle changes (healthy eating, exercise, etc.) and take medications that help slow your heart disease and reduce its symptoms. “The good news is there are new therapies coming out every day,” said Dr. DeVore. “We can help find the option that’s right for you.” To read the original article click here.

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World’s First Partial Heart Transplant Proves Successful in First Year

The AHA! Team — Wed, 29 May 2024 08:13:15 +0000

Journal of the American Medical Assocation via Duke Health – Novel procedure demonstrated valve growth & functionality in newly published study results The world’s first partial heart transplant has achieved what researchers have spent more than a year hoping for DURHAM, N.C. – The world’s first partial heart transplant has achieved what researchers have spent more than a year hoping for — functioning valves and arteries that grow along with the young patient, as hypothesized by the pioneering team behind the procedure at Duke Health. The procedure was performed in the spring of 2022, in an infant who needed heart valve replacement. The previous standard of care — using valves that were non-living — would not grow along with the child, requiring frequent replacement, entailing surgical procedures that carry a 50% mortality rate. A study led by Duke Health physicians, appearing online Jan. 2 in the Journal of the American Medical Association, found that the new manner of valve procurement used during the partial heart transplant led to two well-functioning valves and arteries that are growing in concert with the child as if they were native vessels. “This publication is proof that this technology works, this idea works, and can be used to help other children,” said Joseph W. Turek, M.D., Ph.D., first author of the study and Duke’s chief of pediatric cardiac surgery, who led the landmark procedure. The study also found the procedure requires about a quarter of the amount of immunosuppressant medication than a full heart transplant, potentially saving patients from detrimental side effects that might compound over decades. Turek said the innovation has paved the way for a domino heart transplant, where one heart is able to save two lives. During a domino heart transplant, a patient who has healthy valves but is in need of stronger heart muscle receives a full heart transplant; their healthy valves are then donated to another patient in need, creating a domino effect. “You could potentially double the number of hearts that are used for the benefit of children with heart disease,” Turek said. “Of all the hearts that are donated, roughly half meet the criteria to go on to be used for full transplant, but we believe there’s an equal number of hearts that could be used for valves.” You could potentially double the number of hearts that are used for the benefit of children with heart disease “If you introduce the donated hearts that weren’t being put to use into the supply chain and add the valves from domino heart transplants, that can create a substantial change,” Turek said. The partial heart transplant procedure has been performed 13 times at four centers around the world, including nine at Duke, several of which have been domino heart transplants. Turek said bringing this innovation to a clinical trial would be the next step to achieving the volume in procedures that would change the availability of hearts by a large amount. “This innovation adds a lot to the whole donation community,” Turek said, “because it’s treating more kids, while also honoring the wishes of selfless donor parents who’ve given the ultimate gift. It allows them to offer hope to another child in the process.” Preclinical data was supported by the Brett Boyer Foundation. In addition to Turek, study authors include Lillian Kang, Douglas Overbey, Michael P. Carboni, and Taufiek K. Rajab. To read the original article click here.

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New Heart Valve Could Transform Open Heart Surgery for Millions of Patients Globally

AHA Publisher — Tue, 30 Jun 2020 07:00:15 +0000

University of Bristol via EurekAlert – A new polymeric heart valve with a life span potentially longer than current artificial valves that would also prevent the need for the millions of patients with diseased heart valves to require life-long blood thinning tablets has been developed by scientists at the universities of Bristol and Cambridge. The team’s latest in-vitro results, published in Biomaterials Science, suggest that the PoliValve could last for up to 25 years. More than 1.3 million patients with diseased heart valves need valve replacement therapy globally each year. There are two artificial valves currently available for this; both have limitations either in durability or in biocompatibility. Biological valves are made from fixed pig or cow tissue and have good biocompatibility, meaning patients do not need life-long blood thinning tablets. However, they only last ten to 15 years before failing. While mechanical valves have very good durability, they have poor biocompatibility and patients must take daily blood thinning drugs to prevent life threatening complications due to blood clots. Professor Geoff Moggridge, Head of the Structured Materials Group at Cambridge’s Department of Chemical Engineering and Biotechnology and Professor Raimondo Ascione, NHS Adult Cardiac Surgeon and Head of the Translational Biomedical Research Centre (TBRC) at the University of Bristol have spent three years conducting developmental work and extra-vivo and in-vivo testing on the new PoliValve. The PoliValve, created by Professor Moggridge, Dr Marta Serrani and Dr Joanna Stasiak at Cambridge and Professor Ascione in Bristol, and building on earlier work with Professor Costantino’s group, is made from a special co-polymer and is designed to resemble the flexibility, biocompatibility and durability of a natural heart valve. The device combines excellent durability with biocompatibility, addressing the limitations of current biological and mechanical artificial valves. It is made through a simple moulding process; hence it also reduces markedly manufacture and quality control costs. Professor Moggridge, said: “These impressive results show the PoliValve is a promising alternative for valve replacement surgery. While further testing is needed, we think it could make a major difference to the hundreds of thousands of patients who get valve replacement surgery every year.” Initial testing in animal has been undertaken at Bristol’s TBRC facility as a first mandatory in-vivo testing step to ensure safety. Long-term in-vivo testing is already planned and funded as a necessary additional step before bringing this new treatment to patients. Professor Sir Nilesh Samani, Medical Director at the British Heart Foundation, said: “Patients requiring an artificial heart valve are often faced with the dilemma of choosing between a metallic or tissue valve replacement. “A metallic valve is long lasting but requires the patient to take lifelong blood thinning drugs. Although this medication prevents clots forming on the valve, it also increases the risk of serious bleeding. “Patients who have a tissue valve replacement usually don’t need to take this medication. However, the valve is less durable and means the patient may face further surgery. “The polymer valve combines the benefits of both – it is durable and would not require the need for blood thinning drugs. While further testing is needed before this valve can be used in patients, this is a promising development, and the BHF is pleased to have supported this research.” According to the ISO standards a new artificial heart valve must withstand a minimum of 200 million repetitions of opening and closing during bench testing (equivalent to five-year of life span) to be tested in humans. The new Cambridge-Bristol polymeric valve has comfortably surpassed this. The PoliValve has also exceeded the requirements of ISO standards for hydrodynamic testing, showing a functional performance in-vitro comparable to the best-in-class biological valve currently available on the market. The small feasibility pilot study in-vivo in three sheep at one to 24 hours after surgery has demonstrated the valve is easy to stitch in, no mechanical failure, no trans-valvular regurgitation, low trans-valvular gradients, and good biocompatibility at histopathology. Professor Ascione added: “The transformational PoliValve results from an advanced Bristol/Cambridge-based biomedical cross-fertilisation between experts in biomaterials, computational modelling, advanced preclinical development/testing and clinical academics understanding the patient needs. The new valve could help millions of people worldwide and we aim to test in patients within the next five years.” To read the original article click here.

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Massachusetts Surgeons Perform First-of-Its-Kind Heart Transplant in New England

AHA Publisher — Sun, 12 Jan 2020 08:00:29 +0000

Massachusetts General Hospital via News-Medical Net – A team of surgeons and specialists at Massachusetts General Hospital (MGH) is announcing an achievement in transplant surgery today, having recently performed the largest number of adult heart transplants in the country using what are known as Donation after Circulatory Death (DCD) donor hearts. The five transplants also include the first surgery of this kind for the New England region. For decades, heart transplant cases in the U.S. have been dependent solely upon organs donated after brain death or irreversible loss of brain function. A DCD donor has brain function incompatible with life, but doesn’t meet all criteria for brain death. Life support is removed and if the donor’s heart stops beating within a certain window of time, death is declared and the organ is removed. Outside the body, blood circulation is re-established in the heart using a machine pump while it is being transferred to the recipient. “This is a significant moment not only for MGH, but hopefully for transplant centers around the the country. Patients die each day while waiting for transplants, due to a major shortage of suitable organs. This is one way we can work toward addressing that gap.” David D’Alessandro, MD, surgical director for Heart Transplantation at MGH The first adult DCD heart transplant in the U.S. was performed at Duke University Hospital last month. Duke and MGH are among five centers taking part in a clinical trial for DCD heart transplants, involving the use of the Organ Care System (OCS) designed by Massachusetts-based Transmedics. The portable OCS, often referred to as “heart in a box,” restores the donor organ with warm, oxygenated blood, re-animating it until it can be safely transplanted. OCS was also used during the world’s first DCD heart transplant in Australia in 2014 and in England’s first DCD heart transplant in 2015. “Recent studies have shown outcomes among DCD heart transplant patients overseas have been favorable,” said James Markmann, MD, PhD, chief of the Division of Transplant Surgery at MGH. “I’m confident we will continue to see this program grow at MGH.” The DCD heart transplant trial is expected to run through August of 2021. To read the original article click here.

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