Recently, a 45-year-old patient named Laurie Bartow of Danbury, Connecticut, awaiting an emergency heart transplant, was successfully weaned off an artificial heart pump, prompting doctors to hope that such devices might one day serve as a temporary measure.
Diagnosed with viral cardiomyopathy--a heart infection that causes both ventricles (the heart's pumping chambers) to fail, the patient received an artificial pump and another device to stabilize her heart last May. Typically, such devices are permanent or used to keep patients alive until transplant. This was the first case in which a Novacor brand pump was successfully removed in the United States.
Experts on the process, called explantation, said similar surgeries using other devices have been performed. The observation represents a new development in what cardiologists call "bridge to recovery" medicine, during which the artificial pump, or left ventricular assist system (LVAS), allows the heart to grow stronger and recover.
"This case represents the best of outcomes via advanced cardiac technologies," said John Elefteriades, M.D., chief of cardiothoracic surgery at Yale-New Haven Hospital and the patient's primary surgeon. "When she presented to us, I would have described her condition as extremely critical. She was suffering from biventricular failure and cardiogenic shock. She desperately needed a heart transplant. She needed the artificial heart device to sustain her until a transplant organ would become available. Her overall outlook was not favorable. What has transpired is nothing short of a miracle.
"While the implantation procedure for both devices was very delicate and complicated, the removal of the LVAS was equally challenging because we were basically in uncharted waters. The removal of the LVAS was going to leave Mrs. Bartow's heart on its own. We were extremely concerned about her heart's ability to pump blood successfully minus the LVAS. To our amazement, her heart was able to regain full function without the use of any assist device. It is truly a remarkable story."
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