Heart Transplant and Left Ventricular Assist Devices: Treatment for end stage heart failure
Heart Transplant and Left Ventricular Assist Devices: Treatment for end stage heart failure
Heart Surgeons Dr. Edward Soltesz and Dr. Michael Tong talk about left ventricular assist devices (LVAD) therapy and heart transplant, two options for end-stage heart failure.
Content
9.7 -> we see a lot of patients who have come
13.129 -> to us because they're at the end of the
14.42 -> line they really have no other options
16.669 -> and they're quite ill receiving a heart
19.669 -> transplant is something that very few
23.059 -> people have the advantage of receiving
25.88 -> and it's a gift not only of life it's a
28.7 -> gift of love it's a gift of someone
31.16 -> else's family so I think one of the
33.35 -> things that we impress upon patients is
35.809 -> that this is a gift that they have to
37.79 -> take care of it and this is a gift that
39.68 -> we as caregivers significantly strive to
43.52 -> make certain that goes well for them as
46.31 -> well for their family that's one of the
47.96 -> reasons why the team that we have in the
49.91 -> strategy that we put forth is key
54.34 -> the difficulty with heart transplant is
57.05 -> that to have organ shortage and in the
58.88 -> United States we do only about 3,000
61.07 -> heart transplants a year but the number
62.989 -> of patients who need heart transplants
65.21 -> are a lot more so because of the long
67.61 -> wait times the average wait time is
69.409 -> about a year to a year and a half a lot
71.45 -> of these patients will die on the wait
73.1 -> list if we didn't have any other support
74.899 -> for them so al VADs have been developed
77.179 -> to remedy this situation LVAD is a left
80.24 -> ventricular assist device it is a small
82.429 -> pump that gets implanted into the tip of
84.53 -> the heart that allows the left ventricle
86.869 -> to pump better and it is implanted in
90.079 -> two different strategies the first is a
92.6 -> bridge to transplant these are patients
94.159 -> who are transplant candidates but for
97.759 -> whatever reason they can't wait for a
100.039 -> transplant either they're too sick or
101.719 -> their blood group and size or immune
104.84 -> system is such that it's going to take a
107.509 -> long time to find a transplant for them
109.77 -> the other type of strategy we implant
112.71 -> LVAD xin is what's called a destination
114.78 -> therapy these are patients who for
117.03 -> whatever reason are not transplant
118.799 -> candidates once a device is fully
120.869 -> implanted there is a cable that comes
122.82 -> out we would bring the cable out from
125.22 -> the abdomen area and that cable is then
128.7 -> attached to a computer about the size of
131.61 -> an iPhone that computer will then also
134.16 -> need power so patients will wear two
136.17 -> batteries and the batteries are
137.76 -> typically strapped to their shoulders
139.65 -> like suspenders and the computer itself
142.319 -> is worn usually with either a fanny pack
144.87 -> or inside a bag I think we need to
147.69 -> remember how sick these patients are
149.489 -> patients who have end-stage heart
150.989 -> failure typically have a one-year
153.569 -> survival of less than 50% and often less
157.11 -> than that to survive on el Vettes now
159.45 -> that one-year survival is greater than
161.7 -> 90% for a lot of these patients and a
164.489 -> long-term we've had patients who
165.93 -> continue to live well on an LVAD for
167.58 -> more than 10 years now and so these
169.44 -> devices have come a long ways to
170.94 -> continue to get better within the next
173.01 -> decade or two we may see LVAD to replace
176.07 -> heart transplant as a treatment of
177.6 -> choice for most patients who have heart
179.459 -> failure that would alleviate the fact
181.859 -> that we just don't have enough organs to
183.45 -> go around one of the advantages of the
186.45 -> cleveland clinic is just the sheer
187.799 -> volume of surgeries that we perform here
189.42 -> we've had the luxury of having a very
192.44 -> well-established and long a heart
195.12 -> transplant program the LVAD program
197.34 -> similarly has had great success this
200.43 -> really puts us at the top in terms of
202.14 -> volume across the country the advantage
204.09 -> of a place like Cleveland Clinic is a
206.13 -> multidisciplinary team that we have so
208.35 -> we have a team about 14 cardiologists
210.54 -> and four surgeons that are involved in
212.7 -> the heart failure program in addition we
214.889 -> have a whole slew of other team members
217.17 -> and nurses and there's practitioners a
219.54 -> social worker nutritionist pharmacist
221.79 -> etc and the whole team is working
224.25 -> together for the patients we get
227.34 -> referred patients who are denied surgery
229.35 -> at some other very high volume centers
231.51 -> we do have a very high acuity risk our
235.319 -> patients are very sick that
237.13 -> give us an advantage to patients in the
239.17 -> sense that they know they're being cared
240.52 -> for by teams that have seen just about
241.93 -> everything the difference you see in
244.3 -> patients before and after a heart
246.52 -> transplant LVAD is one of the most
248.65 -> gratifying experiences any human being
251.53 -> can can experience see them back after
254.5 -> all these years and see how well they're
256.39 -> doing and we will do whatever it takes
258.61 -> to accomplish that for every patient it
261.61 -> is a true gift whether it be a
263.8 -> transplant or an LVAD because they're
265.57 -> survivors
266.16 -> [Music]
267.83 -> you
Source: https://www.youtube.com/watch?v=U8rCoDiRaxY