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Patient Weaned Off Artificial Heart Pump

Posted on: Tuesday, 28 June 2005, 21:15 CDT

NEW HAVEN, Conn. -- A 45-year-old patient awaiting an emergency heart transplant was successfully weaned off an artificial heart pump in an operation that doctors said gives them hope that such devices may one day be seen as temporary.

Laurie Bartow was diagnosed with viral cardiomyopathy, a heart infection that causes both ventricles - the heart's pumping chambers - to fail. Doctors at Yale-New Haven Hospital installed an artificial pump and another device that stabilizes the heart May 20.

Normally, such devices are permanent or are used to keep patients alive until their transplant. Doctors said it was the first case of a Novacor brand pump being removed in the United States.

Experts on the process, called explantation, said similar surgeries using other devices have been performed. Bartow's surgery represents the latest development in what cardiologists call "bridge to recovery" medicine, in which the pumps let the heart grow stronger and recover, said Dr. Mandeep Mehra, head of cardiology at the University of Maryland School of Medicine, where heart pumps have been studied.

Bartow, a mother of three who was born deaf, was listed as a top priority on the national heart transplant list, doctors said.

"The virus was extraordinarily strong," said Dr. John Elefteriades, a chief heart surgeon at Yale-New Haven Hospital. "Her heart wasn't beating at all and we didn't hold out much hope for recovery."

After the devices were implanted, Bartow's heart appeared to be getting stronger all by itself.

"We noticed a remarkable thing," Elefteriades said. "On the monitor, we started to see extra blips. We realized it was her own heart awakening."

Doctors slowly began turning down the pumps to lessen their strength. Over time, they decided to try removing it and letting Bartow's heart work on its own. They consulted with her husband, Gerald Bartow, who agreed to the surgery. She underwent the procedure June 9, doctors said.

After surgery, "she was absolutely glowing," her husband said. "She was ecstatic. I've never seen her shine so bright."

Hospital spokesman Mark D'Antonio said that doctors were aware of the procedure being performed two times in Europe with the Novacor pump. The manufacturer confirmed Bartow's surgery was its first in the United States.

"If bridge to recovery is going to be developed as a real option, there has to be some momentum developed and we start with these anecdotal case reports," said Dr. Clyde Yancy, a spokesman for the American Heart Association and a professor at University of Texas Southwestern Medical Center.

Mehra, who was not involved in the surgery, said he expects heart pumps will become more common in helping patients recover from heart attacks and other problems.

"That's where we are going," he said. "These devices are becoming smaller and smaller."

Yancy, who also was not involved in the surgery, said he was "delighted" to hear of the Yale surgery. He said the science likely will continue slowly because the type of heart conditions are so rare and the surgeries so risky.

Bartow will be released with only a few medications to take, doctors said. Her heart is essentially back to normal. Doctors said they could have left the artificial pump in, but long term, it is better if her heart can function on its own.

"We were holding our breath," said Elefteriades. "We were holding our breath really when we turned that pump off completely."

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On the Net:

Novacor: http://www.worldheart.com/products/novacor-lvas.cfm  

Yale-New Haven Hospital: http://www.ynhh.org/

Source: Associated Press/AP Online

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