Our program provides several different services for patients with advanced heart failure including temporary circulatory support, bridge to heart transplantation, and destination or “permanent” therapy with implantable heart pumps.
Destination (“Permanent”) Therapy
Since 1993, the UAHP has been diligently involved with the research and development of permanent ventricular assist devices for heart failure patients. As a CMS-approved center, the UAHP has the capability to implant the left ventricular assist device in patients who do not qualify for a heart transplant. Patients may not be eligible for heart transplant due to their age, certain types of cancer, obesity and other factors.
Patients must meet LVAD therapy criteria and be diagnosed with end-stage heart failure (Class IIIB to IV) to qualify for Destination Therapy. The maximum length of support at our program is currently five years. Many Destination Therapy patients experience prolonged life and the ability to do many normal activities, such as spending time with family, hobbies, driving and traveling. For more information on patient lifestyle, read our Patient Stories.
The UAHP now implants two devices for this therapy: the HeartMate II, which was approved by the FDA for permanent use in January 2010 and the HeartWare HVAD, available as part of an FDA-approved clinical trial.
HeartMate II (Thoratec)
The HeartMate II is a small, silent left ventricular assist device (LVAD) that is implanted below the patient’s heart in his or her abdomen. This device does not replace the heart, but assists the pumping function of the left ventricle. The HeartMate II is capable of pumping up to 10 liters of blood per minute. The pump utilizes only one moving part (a pump rotor), giving it enhanced durability over earlier generation devices. Patients with the HeartMate II are discharged home with a wearable power system. The HeartMate II is FDA approved.
HVAD Pump (HeartWare)
The HeartWare HVAD Pump is a miniaturized left ventricular assist device that is implanted in the pericardial space adjacent to the heart, and may be implanted in small adults and adolescents. The pump is the smallest on the market to date, weighing 140 grams with an outer diameter of approximately 4 centimeters. The HVAD pump utilizes passive magnetic and hydrodynamic forces to levitate and rotate an impeller. Once power is applied to the device, there are no points of mechanical contact between the impeller and the body of the pump, giving it the potential for extended durability. Patients with the HeartWare device are discharged home with a wearable power system. The pump is currently available for Destination Therapy patients through an FDA-approved randomized clinical trial.
Bridge to Heart Transplantation
In the US, the median wait time for a heart transplant is over 4 months and is growing longer due to a shortage of donor organs. The use of implantable heart pumps in Bridge to Transplant Therapy is often necessary for advanced heart failure patients who are at risk of passing away before a matching donor becomes available.
Our center currently implants two devices for Bridge to Transplant therapy: the HeartMate II and the CardioWest Total Artificial Heart.
CardioWest Total Artificial Heart (SynCardia)
The CardioWest Total Artificial Heart is the predecessor of the Jarvik-7 Total Artificial Heart that was implanted in Barney Clark in Utah in 1982. The Total Artificial Heart is an air-driven pump that is implanted as a bridge to human heart transplantation in patients who have severe right and left-sided heart failure. The failing native heart is removed prior to implantation. The pump is driven by a large console that provides compressed air in pulses to power the artificial heart. After implantation of the Total Artificial Heart, most patients experience improved blood perfusion to other organs in the body, physical rehabilitation, and survival to heart transplantation.
Temporary Heart Assist Devices
The Utah Artificial Heart Program offers life-saving temporary assist devices that support patients from several hours to several days. These devices are used if a patient’s heart is rapidly failing, if they need additional hemodynamic support (or blood flow) during a procedure in the heart catheterization lab, or if they suffer unforeseen complications from open heart surgery. Temporary assist devices can be implanted in the catheterization lab in 30 minutes or less.
Impella (Abiomed)
The Impella device is a small, minimally invasive cardiac assist device that can be inserted in the catheterization lab. The Impella pump is located at the tip of a catheter that is advanced across the patient’s aortic valve. Blood is withdrawn from the patient’s left ventricle and delivered to the patient’s aorta, the largest artery in the human body.
TandemHeart (CardiacAssist, Inc.)
The TandemHeart is a temporary ventricular assist device that is also implemented in the heart catheterization lab. An external blood pump is secured to the patient’s thigh and a cannula, or tube, travels to the left side of the patient’s heart to retrieve oxygenated blood. A second cannula allows blood to travel from the pump into the patient’s vasculature.
CentriMag Acute Circulatory Support System (Thoratec)
The CentriMag is an external blood pump connected to the patient’s heart and vessels by cannulae. The CentriMag system can be used to support either the left, right or both sides of the heart. It can also be used along with an oxygenator to support both the patient’s heart and lungs – a therapy called cardiopulmonary support.