wave of the future

Continuous flow heart pumps


By Bonnie James
CONTINUOUS flow heart pumps are going to be the ‘wave of the future’ for treating heart failure, a visiting expert told a cardiovascular symposium hosted yesterday by Hamad Medical Corporation.
“There is 80 to 85% one-year survival in the US in patients fitted with such pumps,” Dr Leslie Miller (Walter’s chair in cardiovascular medicine, Washington Hospital Center and Georgetown University) said.
Approximately 25mn people worldwide are estimated to have heart failure. There are 500,000 new cases a year in the US alone.
“More hospital days are spent for heart failure than any other diagnosis, and these patients are re-admitted more commonly than others,” he pointed out.
Going by figures from the US, 20% of heart failure patients are re-admitted in 30 days, while 50% are back in the hospital in six months.
Mortality following hospitalisation is 12% after 30 days, 33% after 12 months and 60% at five years.
Comparing heart pumps (ventricular assist devices) of pulsatile and continuous flow types, Miller observed that the latter, for example HeartMate II, has been found to have fewer complications.
“There are many therapeutic options for advanced heart failure, and surgical therapies have become the best options,” he observed.
The speaker was of the view that it is important to recognise the risk factors for increased mortality and refer a patient with multiple risk factors for evaluation of new therapies.
Another visiting speaker, Dr Franco Cecchi, expressed hope that medical science would be able, in this century, to cure genetic mutations of cardiomyopathies (diseases of the heart muscle).
“Cardiomyopathies are often familiar diseases with dominant genetic transmission of variable penetrance,” explained the head of the Referral Centre for Myocardial Diseases at the University Hospital of Careggi – Florence, Italy.
Cecchi maintained that cardiomyopathies are often undiagnosed, have longstanding asymptomatic early phase, have progressive clinical course with symptoms and signs of left ventricular dysfunction eventually leading to heart failure which results in premature or sudden death.
There are four main types of cardiomyopathy: hypertrophic (HCM), dilated, restrictive and arrhythmogenic right ventricular.
The speaker stated that patients with HCM (a condition in which the heart muscle becomes thick) are susceptible to sudden death and in a majority of cases, the condition is inherited.