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Clinical Updates
Mechanical circulatory support device newly approved for use in destination therapy
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The HeartMate II®, a left ventricular assist device (LVAD) previously available only for bridge-to-transplant therapy, is now approved for destination therapy in patients with end-stage heart failure. It is only the second LVAD approved by the Food and Drug Administration (FDA) for destination therapy (long-term treatment for patients who are not transplant candidates or who choose to decline transplantation). The device offers many advantages that contribute to better long-term patient outcomes and quality of life. Patients are able to return home and resume an active lifestyle.
Advantages of the new device
Weighing only 12 ounces, the HeartMate II is substantially smaller and lighter than the previous generation destination-therapy ventricular assist device. It is easier to implant and is placed in a preperitoneal pocket just under the left costal margin. A single driveline emerges from the patient’s body, connecting to a controller and battery pack that can be carried in a fanny pack. The battery pack provides up to 12 hours of operation on a single charge, allowing patients to resume their normal daily activities and making the HeartMate II conducive to a better quality lifestyle than previous generation devices. Silent function also contributes to the inconspicuousness of the device.
The diminished size of the LVAD means that patients with smaller bodies are now candidates for long-term mechanical therapy. In the past, many women were precluded from this life-saving technology because of their inability to accommodate the device.
The HeartMate II is a second generation axial flow pump that provides continuous flow — rather than pulses — to help the heart maintain circulation. The single moving part is an impeller blade suspended between two bearings and lubricated by the blood it drives. The HeartMate II impeller blade turns at 6,000 to 15,000 RPM, making it capable of restoring normal cardiac output in patients whose hearts have become severely compromised. The HeartMate II is projected to be more durable than older LVADs that had more moving parts and valves, potentially lasting up to 10 years post-implant.
The Ahmanson-UCLA Cardiomyopathy Center
The Ahmanson-UCLA Cardiomyopathy Center treats patients at all stages of heart failure and offers the full scope of treatments — medical and surgical — up to and including heart transplantation. Patients at UCLA are evaluated by a team of experts and are offered the most appropriate, individualized therapy based on their condition.
UCLA physicians evaluate for heart transplantation many patients who do not go on to receive transplants, either because they do not meet the recipient criteria or through personal choice. UCLA offers these patients other treatment options, including valve surgery, coronary artery bypass surgery and now destination therapy with mechanical circulatory support.
With one of the busiest transplant centers in the region, UCLA surgeons have been implanting the HeartMate II and other LVADs for years as bridge-to-transplant therapy. Our surgical teams, cardiomyopathy specialists and nurses, and VAD coordinators have extensive expertise in pre-implantation assessment, surgical implantation and post-implantation care.
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