12:48pm Wednesday 24th March 2010
By Barry Nelson
Heart patients in the North-East are benefiting from amazing technological progress. Health Editor Barry Nelson finds out more.
THE idea of a permanent implantable heart pump which would render heart transplants a thing of the past may be very close to becoming a reality.
Such a device, which would bring hope to hundreds of patients with heart failure, could be available in only five years, according to Professor Stephan Scheuler, a heart specialist at the Freeman Hospital, in Newcastle.
And Prof Scheuler should know: he has implanted more heart patients with a revolutionary new type of miniaturised heart pump than anyone in the UK.
In the past year, the Freeman team was second in a European league table of specialist centres fitting the new generation of heart pumps.
HeartWare pumps, which have been available in the UK for the past 12 months, have transformed the lives of North-East patients who have suffered heart failure or are waiting for a transplant. They are so successful in letting patients stay in their own homes, allowing them to lead a near-normal life, that some patients are even asking whether they need a heart transplant at all.
“We now have the situation where some of the patients don’t want a transplant,” said Prof Scheuler.
“We had one lady on the phone recently who feels so well she doesn’t want a transplant. She may change her mind but that is how well she feels right now.”
He stresses that the HeartWare pump is still intended to be “a bridge to transplant”, but sees a time when permanent alternatives to transplants will be available.
“Right now, there are patients out there who have been on implantable heart pumps for more than five years,” he said.
“I can see in the next five years this being a real alternative to heart transplantation. If the survival rates are the same, then the patient will have to chose whether to go on the device straight away without waiting for a transplant.”
THIS technological progress could not have come at a better time. “The problem is the number of donor hearts in this country has dropped so dramatically in the past couple of years that it is very unpredictable when a new heart is going to come around,” said Prof Scheuler, who was born in Berlin, but has made the North-East his home.
Two years ago, most patients who needed to be maintained on a heart pump were fitted with a Berlin Heart, an older, bulkier design in which the pumping is done outside the body.
But since April last year, Prof Scheuler’s team has switched to HeartWare pumps for virtually all adult patients.
“The big difference with the HeartWare is that it is a very small, very efficient pump,”
said Prof Scheuler.
“It causes much less trauma when you put it in and you don’t need to create a pocket for it.
The device sits naturally in a sac around the heart.”
Fitting comfortably into the palm of a hand, the HeartWare Left Ventricular Assist System – to give it its full name – uses an electricallypowered centrifugal blood pump.
The device pumps blood from the left side of the heart into the aorta, the large vessel that carries blood from the heart to the rest of the body. Two small motors inside the pump cause an impeller to rotate at up to 3,000 revolutions per minute, driving blood through the system.
A cable from the pump comes out of the patient’s skin and connects to a controller powered by a battery pack. The controller provides the patient with information about the pump’s operation, including an alarm if the batteries are running low.
Prof Scheuler has been impressed at how his patients have fared on the new pumps. “They basically go back to their own life before they had heart failure,” he said.
“We have one guy who is a mayor of a small Lake District town and he does all the stuff he used to do.”
The only thing patients have to remember is that the device only supports the left side of the heart. “The right side of their heart is still diseased and they still have to take their medication and have regular checks,” he said.
Father-of-four John Blas, 52, who lives in South Shields, South Tyneside, was a fit, active vocational trainer when he suffered a massive heart attack on October 22 last year.
“There was no warning at all. I woke up with pains in my chest and that was it,” recalls Mr Blas, who is originally from Brittany, in France, but has lived in the region for 35 years.
At the Freeman, Mr Blas died and had to be revived three times. After he was connected to a Berlin Heart pump his condition stabilised.
That is when Prof Scheuler mentioned the HeartWare pump.
Mr Blas said: “He told me about the Heart- Ware pump and explained that it was pretty new. When he said it would mean I could go home I said, ‘go for it’.”
He was fitted with the pump on November 12 and was able to get home for Christmas.
“It is amazing. I can live virtually normally, I can go out, get the bus and see my friends,”
said Mr Blas, who is hugely impressed with the care he has had.
“I have got what looks like a camera case which I wear over my shoulder.
“That contains the controller and two batteries which give me a total of 12 hours without having to plug into the mains.”
A wire from the controller pack goes into Mr Blas’ stomach and up into the chest and into the pump. “It is strange at first, you can feel the wire just under your skin,” he said.
Mr Blas said he can do virtually anything again – apart from ride his beloved mountain bike. “I can’t ride it yet,” he said, “but I fully intend to.”
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