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New Delhi: There's new hope for terminal heart patients, with a new
pumping device promising to provide rest to the worn-out heart and
even recharge it - adding years and quality to a patient's life.
The Ventricular Assist Device (VAD), or Heartmate II, is
surgically inserted between the chest and upper abdomen and is
powered by a battery. The titanium device is connected to a
monitor worn outside the body that controls the blood flow.
Introducing the device in India and educating doctors about it,
India-born, US-based cardiac surgeon and health economist Mukesh
Hariawala says around 10,000 people across the world have had got
the Heartmate II implanted and the results have been "fantastic".
"Heartmate II has a very huge success rate and very few
complications," Hariawala, who is associated with the Harvard
Medical School Affiliated Hospitals in Boston, told IANS during a
visit here.
"Patients can live for 8-10 years, if the rest of the body stays
well. The device takes care of the pumping function of the heart."
Hariawala, who was felicitated as "India's Most Admired Surgeon"
at Mumbai on Sep 21 by Maharashtra Governor K Sankaranarayan, said
the Heartmate II is implanted in those who are in end-stage or
terminal heart patients, "those who cannot go through angioplasty,
stent or bypass".
It can be implanted in patients of any age, but is given usually
to patients who are 50-plus, especially those waiting for a heart
transplant.
A major advantage of Heartmate II is that the heart "starts
remodeling itself".
Explaining, Hariawala said that with the pumping load reduced, the
"typically diseased and enlarged heart starts reducing in size"
and the patient "is able to move about, climb stairs and his/her
endurance increases".
"The patient lives longer and the quality of life is better," he
adds.
Hariawala was a member of the surgical team that performed the
first bypass surgery on Prime Minister Manmohan Singh in 1990
along with John Wright at Harley Street Clinic in London.
Heartmate II is manufactured by US firm Thoratec, a world leader
with more than 10,000 "successful" implantations and the device is
"soon to be offered to India", he said.
How does Heartmate II work?
One end of the Heartmate II goes into the left ventricle and the
other end into the aorta. The blood empties into the device from
the left ventricle, passes through a magnetic roller that pumps
the blood and goes through the outflow track into the aorta. The
device is connected to a controller that controls how much blood
to pump. It is powered by a low voltage lithium ion long life
battery, which is worn with the monitor on the belt outside the
body.
"The amount of blood to be pumped - depending on the metabolic
need of the patient - is set by the doctor on the monitor," said
Hariawala.
It is an "expensive" device, said the expert, adding "It is a good
mechanical alternative (to the heart) but it is not an artificial
heart.
Each battery has a life of eight hours. The patient wears one on
the monitor and carries a spare, while a third one is being
recharged, he said.
The procedure to implant the device takes between 90 minutes to
two hours, and is performed during open heart surgery.
Most of the implantations have been done in the US, Europe and
Australia, and the demand is increasing in Asia, he said.
(Ranjana Narayan can be contacted at ranjana.n@ians.in)
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