New solutions for congestive heart failure

Published June 13, 2019

Published

For patients with advanced congestive heart failure, the heart is weak and unable to keep adequate blood circulating in the body, resulting in symptoms such as fatigue, shortness of breath and weight gain. If that describes you, or someone in your family, you know that medications can help. A heart transplant is another possibility. Also, a Left Ventricular Assist Device (LVAD) can assist the heart, either long-term, or until a heart is available for transplantation.

What Our Recent Study Revealed

UNMC and Nebraska Medicine were part of a major study that determined a new heart pump is an improvement over previous models, and perhaps as good as a heart transplant itself. These pumps are now available at the Med Center.

The study’s results have been published in a recent edition of The New England Journal of Medicine, with two UNMC faculty, Brian Lowes, M.D., Ph.D., Angle Presidential Chair of Cardiology, and John Um, M.D., Surgical Director of Cardiac Transplantation and Mechanical Circulatory Support programs, as contributing authors.

The new magnetically levitated centrifugal-flow device is smaller than previous models, “about half the size of an average person’s fist,” Dr. Um said. “Historically, these pumps have not been perfect,” said Dr. Lowes. “Limitations existed, such as clotting off, stroke, or bleeding complications, because of anti-coagulation.”

So the search was on to build a better heart pump – and the study results suggest clinician-scientists may have found it.

The study lasted for several years and included more than 1,000 patients nationwide. With more than 60 enrollees, UNMC/Nebraska Medicine was one of the study’s top sites. “We help pioneer these therapies,” Dr. Lowes said. “We’re one of the leading centers in the country, which means the world.” These new pumps not only performed better, but also lasted longer – which in itself is another huge improvement. “It’s a really big deal,” Dr. Um said. “When I first started, these pumps would last maybe 18 months.” Then, they would have to be replaced, and, “each time, it gets harder not only for the surgeon but for the patient.”

The fewer procedures, the better.

A left ventricular assist device (LVAD) can be just what the doctor ordered for a patient who can’t get a transplant, for whatever reason. And the results of this study, “are approaching what we see with a transplant,” Dr. Lowes said. “We’ll probably see more and more patients choosing this as an option.” Dr. Um is grateful to those who chose it as part of a clinical trial.

“A lot of these patients, they’re pretty scared,” he said. “They’re looking at their own mortality. We’re throwing a lot of terms at them. When we’re talking about a new device, a lot of people get overwhelmed. “But people want to be part of medical research, and it’s a wonderful thing.” In this case, it resulted in an advance. “Many of these patients will probably be able to live out their lives with a mechanical heart,” Dr. Lowes said.

 

University Research Makes Advances Available to Clinical Patients

The clinical trial involving the magnetically levitated centrifugal-flow heart pump is a great example of how researchers and clinicians work together – and how UNMC’s research benefits Nebraska Medicine’s clinical patients. In this case, “Patients had already gotten a jump on technology they otherwise would not have access to,” said John Um, M.D., Surgical Director of Cardiac Transplantation and Mechanical Circulatory Support programs. “These patients are getting access to the very latest care.”

Brian Lowes, M.D., Ph.D., Angle Presidential Chair of Cardiology, agreed:  “We’re a large, integrated partner that can offer these things, and partner with industry, to bring this type of therapy to patients in a timely fashion. “We can say to a patient, ‘I can get you the next generation years before the rest of the community as part of a clinical trial.’”

These clinical trials may not always prove successful – but in this case, it was.

“We were able to contribute to this research in a meaningful fashion, and a lot of patients benefited from it,” Dr. Lowes said. The new pump is now commercially available – including at the Med Center. “We’re one of the top 10 centers in the country in terms of delivering this therapy,” Dr. Lowes said. 

Is it time to speak with a cardiologist about your heart disease risks? To make an appointment with one of our advanced heart failure specialists, please call 1-800-922-0000.