Technical innovations have proven their worth. Cardiac support systems are becoming increasingly important as permanent therapy.
At the press conference: Professor Dr Arjan Ruhparwar, patient Kurt M., Professor Dr Jan Schmitto and Dr Günes Dogan (from right). Copyright: Karin Kaiser/MHH
The location of the left ventricular assist device on the heart model. Copyright: Karin Kaiser/MHH
The complete left ventricular assist device including controller, batteries and lead. Copyright: Karin Kaiser/MHH
For many people with advanced heart failure, a heart transplant is the only option for survival. If no donor heart is available, a so-called artificial heart can help patients. Ten years ago, the world's first artificial heart of the HeartMate 3 type was successfully implanted at Hannover Medical School (MHH) - the model is smaller and more technically sophisticated than its predecessor. Did it fulfil expectations? And how is the patient doing today? "We have had very good experiences with the model. Thanks to the technical innovations, there are fewer complications and the patients benefit from the regained quality of life," explains Professor Dr Jan Schmitto, Head of the Cardiac Support Systems and Active Cardiac Implant Technologies profile area at the Clinic for Cardiac, Thoracic, Transplantation and Vascular Surgery (HTTG). The patient, a 66-year-old man from Hessen, is still doing well after ten years.
Cardiac support systems are suitable for short-term and long-term therapy
An artificial heart is not a replacement for the heart, but a mechanical device that helps to pump blood through the body when the patient's own heart is too weak.The MHH is one of the largest centres in Europe that use heart support systems. The HTTG clinic treats up to 100 patients a year with an artificial heart.The device, a left ventricular assist device (LVAD), is implanted directly into the patient's heart.A cable connects the artificial heart to the control electronics and the batteries, which the patient wears outside the body.Such an artificial heart is not only suitable for patients awaiting a transplant.It is also used for long-term therapy when patients cannot be transplanted due to their age or state of health.Some people live with an artificial heart for many years.
Quick recovery after the procedure
Kurt-Josef M. is the first patient in the world to be implanted with the HeartMate 3 artificial heart system. Before his operation on 25 June 2014, his cardiac output was only 13 per cent at times."I suffered from extreme breathlessness and choking and could barely walk," he recalls. This life situation placed a heavy burden on him and his family. The only option left was a heart transplant or the implantation of an artificial heart."After the operation, I was able to recover relatively quickly and take an active part in life again," says Kurt-Josef M. "Since the implantation, Mr M. has recovered from the last to the first stage of heart failure," explains Professor Schmitto. His state of health also allows him to pursue his hobbies again - trips on his motorbike and in his vintage car. Because he feels better in a warm climate, M. spends the winter months in his camper in Spain and Portugal. "If there are any problems, there are also hospitals in these countries that are familiar with the artificial heart, so I can go travelling with peace of mind," says the patient.
Technical improvements bring benefits for patients
The HTTG Clinic implants ventricular assist devices from various manufacturers."We always decide which system to use on a patient-specific basis.This also depends on possible risk factors, among other things," explains Professor Dr Arjan Ruhparwar, Director of the HTTG Clinic.The HeartMate 3 model from Abbott has a number of technical innovations that significantly reduce the risk of complications.For example, the device has specially processed surfaces that are very blood-friendly and allow fewer clots to form.In addition, the position of the pump rotor, which virtually floats in a magnetic field, is constantly corrected magnetically from the outside.This has the advantage that there are no signs of wear on this ventricular assist pump.Another advantage is that HeartMate 3 can generate an artificial pulse.This function can reduce the risk of thrombosis. The system has a pumping capacity of up to ten litres of blood per minute, which corresponds to the full capacity of a healthy heart.
More artificial hearts than heart transplants
"Artificial heart systems can not only prolong life, but also create a whole new quality of life," says Professor Ruhparwar. In view of the lack of donor organs, the support systems are becoming increasingly important.In Germany, around 700 people were on the waiting list for a heart transplant in 2023, but only around 300 donor hearts were available."With the use of artificial hearts, we can prevent patients on the waiting list from dying in many cases," emphasises Professor Ruhparwar.Heart pump technology is developing rapidly.Terms such as "fully implantable" and "miniaturisation" are already a hot topic and will remain so in the future.
Text: Simone Corpus