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Heart failure review chapter 34
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We are entering a new era of advanced heart therapies. There are greater than 550 million people in the U.S. alone with advanced heart failure. Some of the options for heart failure include: medical management of medications, heart transplantation, and the use of mechanical heart pumps.
Patients can be listed for a heart transplant; however, lack of appropriate donors is a huge issue. In the U.S. we have a serious shortage of good heart donors. In 2010 there were greater than 4,000 patients on the heart transplant list, and only 1,900 were transplanted. The wait for a heart transplant is becoming longer and longer with the average wait time ranging from two to six years. Without newer and approved therapies for advanced heart failure, people will die while waiting on UNOS (United Network of Organ Sharing) lists.
The Syncardia Total Artificial Heart is used for biventricular failure. This simply means that both sides of the heart are not working well enough to support body functions. The circulation of the Total Artificial Heart provides increased blood flow to both the lungs and restores blood flow to the kidneys and liver (Temporary Cardio West Total Artificial Heart 1).
Some advantages of the Total Artificial Heart include: 9.5 L/min of increased blood flow through both ventricles, faster bridge-to-transplant, and it eliminates complications caused by a diseased heart, such as kidney and liver failure. (“Syncardia”) “The first Total Artificial Heart implant was performed in Richmond, Va. on April 4, 2006 by a cardiac surgery team at VCU (Virginia Commonwealth University) in the Pauley Heart Center”(Lepley p.1). The major point to remember is that this is a mechanical heart that totally replaces a person’s own heart.
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...al Artificial Heart and the Mortality of Killing." Print 15 Oct. 2011.
Ferris H. Hunt S. Destination Vventricular assist devices for heart failure #205. J. Palliat Med. 2009; 12(10):956-957
"Medical Professionals | SynCardia Total Artificial Heart." SynCardia Systems, Inc. | Total Artificial Heart. Web. 13 Oct. 2011. .
"Syncardia Temporary CardioWest Total Artificial Heart (TAH-t) - P030011." U S Food and Drug Administration Home Page. Web. 16 Oct. 2011. .
"VCU Medical Center Team Implants Total Artificial Heart – VCU News Center." Virginia Commonwealth University News Center. Web. 12 Oct. 2011.
(14) Chieffo A. Transcatheter Aortic Valve Implantation with the Edwards Sapien Versus the Medtronic Corevalve Revalving System Devices: A Multicenter Collaborative Study: The Pragmatic Plus Initiative. 2013;61(8).
Organdonor.gov states, "Each day, an average of 79 people receive organ transplants. However, an average of 22 people die each day waiting for transplants that can 't take place because of the shortage of donated organs."
Stephanie Lee MS in Medical Device Innovation Personal Statement This past January, I had the most enriching opportunity to dissect and study the thoracic cavity of a human cadaver through the Advanced Cardiac Anatomy course held by the UMN. For the first time, I held a human heart within my hands, studied its anatomy, and was also able to closely examine the placement of a dual-chamber defibrillator. My company, Heraeus Medical Components, specializes in products for cardiac rhythm/heart failure management, so this was extra meaningful for me to not only see the leads, but also follow them to the sites of therapy within the heart. In a room of twenty-four cadavers, could I have somehow impacted any one of these patients’ lives?
There are four different categories of treatment: lifestyle changes, surgical procedures, non-surgical procedures, and medications. Lifestyle changes include having a healthy diet; increasing physical activity; eliminating cigarettes, alcoholic beverages, and illicit drugs; and getting enough rest and sleep; losing excess weight. These lifestyle changes are to lower the patient’s blood pressure, cholesterol, and reducing any other future medical conditions. There are also surgical options to help cure, prevent, or control cardiomyopathy. Surgical method include a septal myectomy, surgically implanted devices, and a heart transplant. A septal myectomy is used to specifically treat hypertrophy cardiomyopathy which is where the heart muscle cells enlarge and cause the walls of the ventricles to thicken. The thickening of the walls may not affect the size of the ventricles but instead may affect the blood flow out of the ventricle. Usually along with the ventricles swelling, the septum in between the ventricles can become enlarged and block the blood flow causing a heart attack. When medication is not working well to treat hypertrophic cardiomyopathy, a surgeon will open the chest cavity and remove part of the septum that is blocking blood flow. Surgically implanted devices include a pacemaker, a cardiac resynchronization therapy device, a left ventricular assist device, and an implantable
Takeda A, Taylor SJC, Taylor RS, Khan F, Krum H, Underwood M. (2012). Clinical service organisation for heart failure (Review). Cochrane Database of Systematic Reviews. Issue 9. Art. No.: CD002752. DOI: 10.1002/14651858.CD002752.pub3.
The development of the artificial heart began in the early 1950’s. The initial prototype, developed in 1970’s by the artificial developmental staff at the University of Utah, allowed 50 hours of sustained life in a sheep. Although this was called a success, the implantation of the artificial heart left the sheep in a weakened state. It wasn’t until late 1970’s and the early 1980’s where the improvement of the artificial heart actually received attention as a possible alternative to a heart transplant. The remodeled product of the early 1970’s did more than just the 50 hours of sustained life; it enabled the cow to live longer and to live a relatively normal life, with the exception of a machine attached to the animal.
..., Welsh R, Feindel C, Lichtenstein S. Transcatheter aortic valve implantation: a Canadian Cardiovascular Society position statement. Can J Cardiol. 2012;28:520-8.
“US Markets for Heart Valves.” SAGE Sourcebook of Modern Biomedical Devices: Business Environments, 2007. 21 April 2011.
middle of paper ... ... Circulation: Journal of the American Heart Association 88 (1993): 353-57. AHA Journals. Web.
“In 1984, a baboon heart was transplanted into a newborn infant, Baby Fae, who had hypoplastic left heart syndrome and lived 20 days after heart surgery” (Bailey LL, Nehlsen-Cannarella SL, Concepcion W, et al. Baboon-to-human cardiac xenotransplantation in a neonate. JAMA. 1985 Dec 20.
Currently, more than 118,617 men, women, and children are waiting for a transplant. With this high demand for organ transplants, there is a need for supply. According to the OPTN Annual report of 2008, the median national waiting time for a heart transplant is 113 days, 141 days for lungs, 361 days for livers, 1219 days for kidneys, 260 days for pancreas, 159 days for any part of the intestine. With this world of diseases and conditions, we are in desperate need of organs. Organ transplants, followed by blood into a donated organ transfusions, are ways medical procedures are helping better the lives of the patients.
Moisse, Katie. “Stem Cells: New Hope for Heart Failure Patients”. Abcnews.com. 14 Nov 2011. Web. 15 Nov 2011.
... patients with heart failure: Impact on patients. American Journal of Critical Care, 20(6), 431-442.
After her doctor’s visit that she reluctantly went to, she announced to the family that she was suffering from a damaged heart valve. We were all terrified about what would happen to her, but she assured us that the doctor said it could be fixed with a minimal risk.
...& Hamilton, G. A. (2010). The long-term lived experience of patients with implantable cardioverter defibrillators. MEDSURG Nursing, 19(2), 113-119.