Heart Failure and Transplantation Program
Total Heart Transplants
and Ventricular Assist Devices (VADs):
Surgical
Activity 1998
- 2005
The Heart Failure and Transplantation Program at the Hospital of the University
of Pennsylvania, under the leadership of Rohinton
J. Morris, MD, and Mariell
Jessup, MD, is one of the busiest programs in the United States. Close to 550
heart transplant patients between 18-65 years of age are currently followed at
Penn.
The Heart Failure
and Transplantation Program at HUP
has a donor heart wait time of 4.5
months, a significantly lower wait
time thant the national and regional
averages of 7.9 months and 10.2 months
respectively.
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More than 8,000
patient visits annually to the Penn
Heart Failure and Transplantation
Program over the last five years. |
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Penn's
multidisciplinary team includes cardiologists,
cardiovascular surgeons, nurses, transplant and
VAD coordinators, social workers, as well as
specialists in cardiac imaging, arrythmia management,
cardiac anesthesia, infectious disease, immunology
and rehabilitation medicine – all
dedicated to the management of patients with
heart failure.
Types of VAD Implantations 1995-2005
As newer and different types of VADs are developed, the University of Pennsylvania
Health System has the experience and expertise to be at the forefront for testing
these devices. Axial flow devices, which constantly spin at 6-10,000 rpm instead
of rhythmically pumping, are currently in trial at HUP. In the coming year,
HUP will be one of six centers in the United States trained to provide a total
artificial heart as a bridge to transplant.
Penn's goal is to provide a full range of services
and maintain its national leadership in the field
of mechanical assist technology for the failing
heart.
Progression in VAD Capabilities at Penn
- 2006 - Total Artificial Heart
- 2005 - Thoratec® HeartMate® II,
Axial Flow VADs
- 2001 - TandemHeart® pVAD
- 2000 - Arrow LionHeart®
- 1998 - Thoratec® Paracorporeal PVAD
- 1997 - TCI HeartMate® VE
- 1996 - ABIOMED BVS® 5000
and Bard CPS
- 1995 - TCI HeartMate® IP
- Prior to 1995 - Biomedicus Centrifugal Pump
and ECMO
Looking Forward
The future outlook for ventricular assist devices is very exciting at Penn. Not
only are the materials, batteries and pumps continually advancing, but so is
the understanding of how patients can live with a machine assisting their heart.
These new generation VADs will be smaller and safer. They will be used to improve
the quality of life in patients with debilitating heart failure.
The size of
the devices will afford Penn surgeons to place them in patients previously
deemed non-candidates such as women, children
and smaller men. Furthermore, these technologic
advances will extend the device's useful life from two years to five to 10
years. The Syncardia Total Artificial Heart will
allow Penn to successfully transplant patients
that otherwise would have died.
"Penn has a
huge program with terrific outcomes,
making us the leader among cardiovascular
centers in the region," said Mariell
Jessup, MD, Medical Director, Heart
Failure and Transplant Program.
Heart
failure is the leading cause of hospital
admissions,
and subsequent death, in the country
today. The most
common causes of heart failure include:
coronary artery
disease, complex valvular heart disease,
cardiomyopathy,
and myocardial infarction. The incidence
of chronic
heart failure is rising as the population
continues to age.
Optimal therapy for
end-stage heart failure includes
a multidisciplinary approach using
state-of-the-art
drug therapy, specialized heart failure
pacemakers and
defibrillators and dedicated electrophysiology
cardiologists
to manage these devices, high-risk
coronary revascular -
ization, complex valvular reconstruction,
and ventricular
remodeling surgery. For patients
who are too sick for
traditional therapies, heart transplantation
and ventricular
assist devices (VAD) surgery are
available.
“I
think the single most important thing
about Penn
is the breadth and depth of experience.
For any cardiac
condition a patient may have, there
is an expert at Penn
who is likewise strengthened by a
tremendous infrastructure
of facilities and personnel. A surgical
program is nothing
without strong cardiology support,
and an excellent cardiac
program, by definition, includes
a superb surgical team.
They are one and the same, and dependent
on each other
for the total care of the patient,” notes
Dr. Jessup.
If heart failure cannot
be surgically or medically treated,
Penn offers mechanical assist options,
either as a bridge to
transplant or a permanent destination
therapy for those
who are deemed to be non-transplant
candidates. |
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