Pump gives hope to patients queuing for hearts
It has the look of an old-fashioned harness, but a groundbreaking blood-pumping device can add years to the life of heart patients stuck in the queue for a transplant.
Yesterday, surgeons at Queen Mary Hospital, Pok Fu Lam, gave details of the first operation to implant the device in Hong Kong, hailing it as a success and a development that gives hope - and time - to would-be transplant patients.
The recipient was a 31-year-old commercial driver surnamed Tse, diagnosed with acute heart disease in 2003.
Tse spent 51/2 hours under the knife on August 31, as 16 medical staff took part in the delicate operation.
'The operation went off quite smoothly; he was taken off the ventilator 24 hours later since he was in a very good condition,' said Dr Subid Das, consultant and chief of service of the Department of Cardiothoracic Anaesthesia at the hospital.
Tse said: 'You don't always get opportunities like this.' He has been making a very rapid recovery and should be fit to be discharged from the hospital soon, doctors say.
The palm-sized ventricular assistance device - HeartMate II LVAD - is a magnetic-field-driven pump connecting the highest point of the heart with the main artery, the aorta, which provides continuous blood flow. Outside the patient's body there is a pack containing two batteries, and there is an external controller.
More than 4,000 have been fitted in patients worldwide. The device differs from the commonly known pacemaker, which generates a current to make a heartbeat.
Pacemakers are used in patients whose heart rate is 'extremely slow', Das explained.
The HeartMate functions as a pump to provide blood to the body when the left ventricle can no longer deliver blood to the aorta.
When end-stage heart failure patients cannot find a suitable heart, the device gives them a window of opportunity, Das said. The device can prolong patients' lives for years.
Due to the lack of organ donors in Hong Kong, 30 to 33 per cent of patients on the transplant waiting list die before they get a chance to get a new heart. From 1992 to this year, 170 patients were found to be suitable for heart transplants, but 52 of them died waiting. Until September this year, 105 heart transplants were performed by the department at Queen Mary Hospital. Dr Cheng Lik-cheung said: 'On average, there were six to eight cases for heart transplant every year.'
Das said: 'With the ventricular-assistance device, we have the means to keep a patient in a reasonably good condition, and give him an extended period of time while waiting for a heart transplant, which is a definitive, and the best, treatment.'
The successful implant marked another surgical milestone in Hong Kong. This month, a woman underwent heart and liver transplant surgery at Queen Mary Hospital. The 27-year-old received a brain-dead donor's heart and liver. Surgeons then transplanted her still useful liver into a 62-year-old man with liver cancer. It was the city's first combined heart and liver transplant with a sequential liver transplant.
Since 1992, 170 patients have been found suitable for heart transplants, but the number that died waiting is: 52