The MUHC is pleased to announce the first successful Canadian implantation of a new long-term mechanical heart as an alternative to heart transplant. On 23 November 2006, the MUHC Heart Failure team implanted the HeartMate II mechanical heart in 65-year-old Gerard Langevin, of Côteau-du-Lac, Quebec. The HeartMate II, which may last up to 10 years, is being used as part of a clinical trial at the MUHC. It represents a new generation of mechanical heart and the first real long-term alternative to a heart transplant.
"Although several HeartMate II implantations have been conducted in the US, Mr. Langevin is currently the only person in Canada to be fitted with this new technology and we are proud to announce today that he is going home," says Dr. Renzo Cecere, director of the Mechanical Assist Program, surgical director of the Heart Failure and Heart Transplant Program of the MUHC, and the surgeon who conducted the three-hour operation to implant the HeartMate II.
The HeartMate II is currently part of a clinical trial administered by the manufacturer Thoratec at selected hospitals in the USA and Canada; as such, this device has yet to be approved for use in either country. The MUHC, which has the largest mechanical heart program in Quebec, was chosen to participate because the complex nature of the surgical procedure required an experienced heart failure team and a comprehensive multidisciplinary program. Only one other Canadian hospital — the Toronto General Hospital — was invited to participate in the study.
"Our patient suffered from severe heart failure after a heart attack in July 2006," says Dr. Nadia Giannetti, medical director of the Heart Failure and Heart Transplant Program of the MUHC. "Despite all the conventional therapies, his heart remained very weak, and he had become unable to live a normal life." Due to other medical conditions, Mr. Langevin was deemed an unsuitable candidate for transplant. His organs started to fail and he was readmitted to hospital many times. "Previously we would have had little else to offer Mr. Langevin, and his heart would have continued to deteriorate," says Dr. Giannetti. "But because of our access to the HeartMate II, he is now doing very well and can expect to do so for many years to come."
"Before receiving my mechanical heart, I couldn't do anything at all. Even walking a few steps was difficult because I was so weak and my breathing was so bad," says Mr. Langevin. "Now, with this new mechanical heart, I have lots of energy, and my breathing is great even while doing activities."
Similar in size and weight to a standard "D" battery, the HeartMate II is significantly smaller than any previous mechanical heart. The device is internal and operates silently through a cable connecting to the battery. An interesting feature of the HeartMate II is that the device provides a continuous flow of blood, so the patient has no pulse. One of the most important aspects of this new technology is its use as a destination therapy. "This means that rather than acting as a bridge to transplant, the HeartMate II, with its greatly expanded lifespan compared to previous mechanical hearts, can be considered an alternative to a heart transplant," says Dr. Cecere. "Because of the lack of adequate donor hearts for people with end-stage heart failure, there is a great need for alternatives to transplant. Now we finally have an off-the-shelf device that can be implanted immediately as a long-term alternative."
The McGill University Health Centre (MUHC) is a comprehensive academic health institution with an international reputation for excellence in clinical programs, research and teaching. The MUHC is a merger of five teaching hospitals affiliated with the Faculty of Medicine at McGill University — the Montreal Children's, Montreal General, Royal Victoria, and Montreal Neurological Hospitals, as well as the Montreal Chest Institute. Building on the tradition of medical leadership of the founding hospitals, the goal of the MUHC is to provide patient care based on the most advanced knowledge in the health care field, and to contribute to the development of new knowledge. www.muhc.ca
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