University of Louisville/Jewish Hospital program helps avoid, delay heart transplant
Some patients with advanced heart failure caused by cardiomyopathy, the deterioration of function of the heart muscle, are benefitting from a new recovery protocol at the University of Louisville and Jewish Hospital, a part of KentuckyOne Health.
Led by Emma Birks, M.D., Ph.D., FRCP, director of the Jewish Hospital Heart Failure, Transplant and Mechanical Support Program, the program treats advanced heart failure patients who have left ventricular assist devices (LVADs), also known as heart pumps, that help the heart function. Using a specific combination of medications which includes ACE inhibitors, spironolactone, beta blockers, angiotensin receptor blockers and digoxin, in combination with the LVAD the elements work together to strengthen the patients' hearts.
Birks, professor of medicine, physiology and biophysics at the UofL School of Medicine, monitors the patients closely, and once the heart function improves to normal levels, the LVAD is removed. Once the LVAD is removed, medication therapy remains ongoing for patients, but they are able to function normally and return to work and other daily activities.
"These patients have a very good quality of life, much better, in fact, than if they continued with the LVAD alone or received a heart transplant," Birks said.
The program has led to the successful removal of LVADs from 11 patients at Jewish Hospital in just 18 months. The only other center in the United States to have removed LVADs using this protocol is the Texas Heart Institute, where 20 devices have been removed in the last 10 years.
The average time on the medication before the LVAD is removed has been six months, but it can be more than a year.
"We don't rush it," Birks said. "The patients are closely monitored to determine the right timeframe."
Jewish Hospital is the second facility in the country to remove LVADs from patients using the protocol, which was pioneered in England by Birks and her mentor, a well-known heart surgeon, Dr. Magdi Yacoub.
Upon Yacoub's retirement, Birks carried forward the work he began in England in 1998, which led to the recovery protocol.
The recovery protocol combines an LVAD with a cocktail of oral heart failure medications in a treatment protocol that led to heart recovery and the removal of the LVAD in patients. The success of the protocol opened the possibility that some advanced heart failure patients may forgo a heart transplant. Birks brought the program to Jewish Hospital in late 2009 when she joined UofL.
A collaborative study on the protocol in the United States led by Jewish Hospital and UofL, will begin in the coming months with seven total centers participating, including the University of Louisville, Texas Heart Institute, University of Pennsylvania, University of Pittsburgh, Cleveland Clinic, University of Michigan and Montefiore in New York.
The average life expectancy following a heart transplant is 10 years. For younger heart failure patients with an LVAD, using the protocol can prolong their life expectancy by helping them to delay or avoid a heart transplant.
"The most rewarding thing in medicine is to help people heal," Birks said. "If you have a young person who is dying and you can help them avoid a transplant and return to good health, that is the ultimate challenge and it is very rewarding."
The program also has benefits for other heart failure patients because it reduces the number of patients on the transplant list and preserves a precious transplanted organ for others in need. Patients who are able to have their LVADS removed also do not require the extensive immunosuppressant drug therapy necessary following a transplant.
Provided by University of Louisville
- Mechanical 'artificial hearts' can remove need for heart transplant by returning heart to normal Nov 02, 2006 | not rated yet | 0
- New patient guidelines for heart devices Apr 17, 2011 | not rated yet | 0
- Newer heart devices significantly improve survival, complication rate and quality of life Nov 17, 2009 | not rated yet | 0
- Long-lasting mechanical heart implanted for the first time in Canada in heart-failure patient Oct 12, 2010 | not rated yet | 0
- Study examines earlier use of heart pumps in growing group of heart failure patients Jan 24, 2011 | not rated yet | 0
- Motion perception revisited: High Phi effect challenges established motion perception assumptions Apr 23, 2013 | 3 / 5 (2) | 2
- Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update) Apr 02, 2013 | 4.5 / 5 (11) | 5
- The visual system as economist: Neural resource allocation in visual adaptation Mar 30, 2013 | 5 / 5 (2) | 9
- Separate lives: Neuronal and organismal lifespans decoupled Mar 27, 2013 | 4.9 / 5 (8) | 0
- Sizing things up: The evolutionary neurobiology of scale invariance Feb 28, 2013 | 4.8 / 5 (10) | 14
Absorption of light by spherical nanoparticle
2 hours ago Hello Can anyone tell me how the absorption of a polystyrene nanoparticles scales as a function of its diameter. The particle is spherical and...
Solvability of a circuit
6 hours ago Let's say I have a circuit consisting only of a finite number of batteries and resistors, all ideal. Given an arbitrary shape of this circuit, will I...
Question about perception of colors around light sources
10 hours ago When I look at a distant light source (like car headlights, or street lamp lights) I notice colors of the visible spectrum (as separated (as in after...
Does a charged particle rotate when traveling through a static Bf?
12 hours ago I have been looking at mass spectrometers, in particular the interactions between the Bf ind of a charged particle in motion in a static Bf of the...
Find a link between physics and assignment problems
13 hours ago Hi ! I've been working about assignments problems and how to solve them. I will have to do a presentation about it in few weeks. However, I'll...
Light as a source of electricity
13 hours ago Hello Dear Fellows! We all know that light is an electromagnetic wave and also we know that an antenna receives EM waves and...
- More from Physics Forums - Classical Physics
More news stories
(HealthDay)—Blood levels of free fatty acids are associated with insulin resistance during young adulthood and cardiovascular risk factors in later adulthood, according to a study published online May 13 ...
Cardiology May 17, 2013 | not rated yet | 0 |
An experimental, inexpensive iPhone application transmitted diagnostic heart images faster and more reliably than emailing photo images, according to a research study presented at the American Heart Association's Quality ...
Cardiology May 17, 2013 | not rated yet | 0
Extracorporeal membrane oxygenation (ECMO), a procedure traditionally used during cardiac surgeries and in the ICU that functions as an artificial replacement for a patient's heart and lungs, has also been used to resuscitate ...
Cardiology May 17, 2013 | not rated yet | 0
Age has little to do with how patients should be treated after suffering a stroke, according to new research from the University of Georgia.
Cardiology May 17, 2013 | not rated yet | 0 |
Depressed middle-aged women have almost double the risk of having a stroke, according to research published in Stroke: Journal of the American Heart Association.
Cardiology May 16, 2013 | not rated yet | 0
A novel study reports that white men and women of European descent inherit common foot disorders, such as bunions (hallux valgus) and lesser toe deformities, including hammer or claw toe. Findings from the Framingham Foot ...
20 minutes ago | not rated yet | 0 |
Whole-cell pertussis vaccines were more effective at protecting against pertussis than acellular pertussis vaccines during a large recent outbreak, according to a new Kaiser Permanente study published in Pediatrics.
7 minutes ago | not rated yet | 0 |
Touted for safety, ease and patient convenience, peripherally inserted central catheters have become many clinicians' go-to for IV delivery of antibiotics, nutrition, chemotherapy, and other medications.
29 minutes ago | not rated yet | 0
Researchers at Mayo Clinic have developed a promising method to distinguish between pancreatic cancer and chronic pancreatitis—two disorders that are difficult to tell apart. A molecular marker obtained from pancreatic ...
13 minutes ago | not rated yet | 0
Scientists at Johns Hopkins have turned their view of osteoarthritis (OA) inside out. Literally. Instead of seeing the painful degenerative disease as a problem primarily of the cartilage that cushions joints, ...
13 hours ago | 4.8 / 5 (5) | 0 |
In their quest to learn more about the variability of cells between and within tissues, biomedical scientists have devised tools capable of simultaneously measuring dozens of characteristics of individual ...
13 hours ago | 5 / 5 (3) | 0 |