Is There An Alternative to Heart Transplant?

About a million heart disease patients died of heart failure worldwide every year while there were only about 3,000 cases of heart transplant being carried out. Heart transplant requires traumatic surgery and patients have to take large amounts of medications to avoid rejection. Many of the victims of heart failure could have survived if suitable organs (hearts) could be found in time for heart transplant.

New Zealand researchers from University of Auckland have developed the technology for a wireless heart pump that they believed could not only save thousands of lives but also offer an alternative to heart transplant.

According to the announcement made by the researchers on September 16, 2009, the technology uses magnetic fields to transfer power to heart pumps through a person’s skin instead of using wire cables that would often cause serious infections.

A coil, which can be put in a pocket, is placed outside the patient’s body, while another coil is placed inside the body near the collarbone to pick up the magnetic field for producing the power for the pump. A battery installed inside the body can also store enough power to operate the pump for about an hour.

Traditional wired heart pumps have been used to keep patients alive while they await heart surgery. However, the wire cable that is required to go through the patients’ stomachs and chests can just cause serious, and sometimes fatal, infections for about 40 percent of patients. Meanwhile, the wires can also break and restrict a patient's movement.

This is certainly not a new concept, but previous attempts in making wireless heart pumps produced too much heat. The new technology is able to eliminate the heating problem by delivering exactly the right amount of power.

The trials on patient are expected to begin within 2 years. If everything goes fine, these wireless heart pumps could be implanted in about 50,000 patients each year around the world within 10 years, according to the researchers.

It is hoped that the wireless heart pump could eventually replace heart transplants and become a viable alternative for heart failure patients.

Which Hospital Should One Go For Heart Transplant?

When patients suffer serious heart disease that causes their hearts to fail, the only thing the doctor can do for them is to perform a heart transplant if everything else are tried for.

No doubt, heart transplant is a sophisticated surgery, yet it is not uncommon nowadays as many hospitals are doing such procedures. However, is there a way that the patients can evaluate which hospital is best for the procedure, in view of the high risk and cost involved? The key is to check the surgical volumes to see which hospitals teams operating at their peak skill level.

According to the prevailing guideline set by US Centers for Medicare and Medicaid Services, which qualifies hospitals for federal reimbursement, a hospital can be considered as a high-volume center if at least 10 procedures were performed every year. The previous figure was 12.

However, a new study, presented on January 30, 2008 at the Society of Thoracic Surgeons meeting in Fort Lauderdale, Florida, argued that the number of procedures should be at least 14 instead. The researchers from Johns Hopkins University, Baltimore, Maryland studied 14,401 subjects who underwent heart transplant in the United States between 1999 and 2006.

Their findings indicated that patients’ mortality at 30 days and at 1 year after heart transplant increased as the annual procedure volume decreased. For example, a center that performs more than 40 heart transplants per year has less than 1 percent for the patient’s mortality rate 30 days after surgery. On the other hand, centers having less than 10 procedures performed, the 30-day mortality rate is increased by 80 percent.

However, once 14 cases per annum were reached, each additional procedure would have very little impact on the risk of death. Therefore, 14 were taken as threshold.

The researchers also revealed that the majority of the 143 United States medical centers that are licensed to perform heart transplant in fact do fewer than 14 cases per year. According to their figures, less than 5 centers do more than 40 and less than 10 do more than 30 procedures. They also blamed many low-volume hospitals just simply refuse to stop their program despite of very poor result.

Is It Possible for a Teenager to live without a Heart for nearly 4 Months?

An American teenager of age 14 managed to survive for 118 days without a heart. She suffered from dilated cardiomyopathy, which is a condition that the patient's heart becomes weakened and enlarged and could not pump blood efficiently. This type of heart disease would require her to undertake a heart transplant for her survival.

On November 19, 2008, doctors in Miami announced that the young patient was kept alive by a custom-made artificial blood-pumping device, and they believe that this was the first time a child had survived in this manner for such a long period. In fact, an adult patient in Germany had been kept alive for 9 months without a heart.

At a news conference at the University of Miami/Jackson Memorial Medical Centre, the young girl seemed very weak and admitted that the experience was very scary. She just felt that she was like a fake person who did not really exist. Meanwhile, she was so afraid that the device might just malfunction at any moment.

Earlier on July 2, she had a heart transplant at Miami’s Holtz Children’s Hospital but the new heart failed to work properly and the doctors had to remove it quickly. Then, the doctors had to implant 2 heart pumps, made by Thoratec Corp of Pleasanton, California, to keep her blood flowing while she was fighting a host of ailments and recovering her strength. After almost 4 months, she had another heart transplant on October 29. Though she remained hospitalized, she was mobile during the period of 118 days, to be exact.

The young patient also suffered renal failure and a kidney transplant was carried out the day after the second heart transplant. Though her prognosis was good, there is a 50 percent chance that a heart transplant patient will require a new heart some 12 or 13 years after the first surgery.

Who Is The First Patient To Have Artificial Heart Transplant In Asia?

In 2003, Mr Venkatakrishniah, a 54-year-old Indian diabetic patient, suffered a heart attack. After the bypass surgery, his condition worsened and he could not walk beyond 6 steps. As such, he had to quit his job as an engineer at a state-owned Power Transmission Corporation because he was unable to work.

Under the guidance of a team of US experts from the University of Minnesota, a group of surgeons at Bangalore's Narayana Hrudayalaya implanted in him a ventricular assist device called Ventrassist (Left Ventricular Assist Device) in a four-hour operation on March 20, 2008.

Narayana Hrudayalaya, set up in 2001, was situated in Bangalore. The hospital is well known for its excellence and is one of the world’s largest Pediatric heart hospitals. Two of the surgeons who performed the operation had flown earlier to the University of Minnesota for 3-month training.

After the operation, Mr Venkatakrishniah revealed in an interview that he can now walk, and even climb stairs, and he is planning to work again.

What is Ventrassist? It is a device, 60 mm in diameter and weighs 298 g, is implanted in the lower part of the chest, just below the heart. In order for it to function, an external battery has to be connected to the device by a cable and the battery has to be recharged every 4 hours. Ventrassist is being manufactured by an Australian based company and is a new third generation implantable blood pump designed as an alternative to heart transplantation to people with heart failure.

Normal heart transplants, which may be out of reach for many patients because of the limited number of donor organs available. Furthermore, whether the donor organs are suitable for patients also pose a problem. In India, millions of people suffer heart failure and each year many die in absence of donors.

For the past 8 years, surgeons in the United States and Europe have already implanted such “new-generation” artificial hearts in 220 patients. Bangalore’s operation was the 221st of its kind but it also marked the first in Asia.

Ventrassist used in the Bangalore’s operation cost about 3.4 million rupees, which is certainly not cheap for the patient. Nevertheless, the hospital costs, which added up to about 600,000 rupees in Mr Venkatakrishniah's case, were waived. Despite the high cost, the hospital has already received inquiries from more than 100 patients in India and overseas since the operation.

More information about the Bangalore's operation may be viewed at

Can A Man Survive Without A Heart?

I bet you would be a little astonishing by just looking at the title and probably asked yourself, ‘How can a man live without a heart?’

In fact, there is nothing wrong about the title. In Taiwan, a 60-year-old retired electrician lived for 16 days without a heart but supported by 2 artificial heart-lung machines while he was waiting for heart transplant at the National Taiwan University Hospital (NTUH). He is believed to be the world’s first heartless survivor.

During January 2008, the retired electrician, who had no prior record of major illnesses, suffered from severe coughing and displayed flu-like symptoms. On February 12, he was admitted to Chi Mei Medical Centre (CMMC) in Southern Tainan City.

He was diagnosed with infective endocarditis - a bacterial infection that can seriously damage the lining of the heart's chambers and valves. His heart failed just a day after and doctors had to perform emergency surgery. His entire heart was removed because the damage was so extensive.

The patient’s family took only 20 minutes to decide the removal of the heart but the operation required 9 hours. The patient’s son, who was a doctor with CMMC, understood the risk and helped the decision.

After the removal of heart, the patient was connected to an 'Extra-Corporeal Membrane Oxygenation' (ECMO) machine. ECMO is the artificial heart-lung machine normally used to support a patient's damaged or infected heart or lungs until a donor of heart is found.

In order to have a higher chance of getting donor in Taipei, the patient was transferred the next day by an ambulance to the top hospital in Taiwan, NTUH. The journey took about 5 hours.

Upon arrival at NTUH, a second ECMO machine was connected to the patient. Artificial arteries transferred blood from the gaping hole in his chest to an external blood pump and artificial lung. The blood was warmed and filtered before being returned to his body. During the waiting period, he suffered blood infections twice.

The doctors had also considered but later on dropped the option of an artificial heart transplant because they were concerned about the risk of infection given his condition. A donor was eventually found on February 29, and he was discharged on April 1 and he is now recovering at home.

When The World's First Heart Transplant Operation Was?

Heart transplant operations are not uncommon nowadays. With the current available technology and know-how, performing a heart transplant is not really a big issue, as long as there is suitable organ.

But, do you know when the world’s first heart transplant operation was?

Medical history was indeed rewritten 40 years ago in the middle of the night at a Cape Town hospital. Christiaan Barnard, a South African surgeon, was the very first doctor who carried out the heart transplant.

The patient in the first heart transplant is Louis Washkansky, a 53-year-old diabetic with incurable heart disease who had suffered three heart attacks.

Dr. Barnard had already practised the basic surgical technique for the transplant in the laboratory. But the technique was pioneered by other surgeons on animals. What he needed was just one donor to put this knowledge into practice.

On the night of the December 2, 1967, a 25-year-old woman was fatally injured in a car accident. Her blood type matched that of Washkansky's and her father agreed that her heart could be donated for the surgery. However Washkansky did not survive for long and died 18 days later after developing double pneumonia as a result of the immuno-suppressive drugs he was taking.

Dr. Barnard had never thought that he could turn himself from a unknown surgeon in South Africa to a renowned surgeon around the world. The failure in operation had, however, made him the target of criticism for rushing into the operation when so little was still known about immuno-suppression.
Nevertheless, the criticism did not prevent this type of operation from becoming popular; some 100 heart transplant attempts were carried out in the following year.

Professor Barnard was described by his colleagues as a very dynamic and exciting person, and they found him very challenging to work for. While continuing transplanting heart, he was pioneering other techniques such as 'piggyback' transplanting in which a second heart was put into a patient while leaving the first in place. He also became the first to carry out a heart-lung transplant.

Having no one to conform, Professor Barnard admitted he had often practiced passive euthanasia and regularly clashed with South Africa's government over apartheid issues.

Professor Barnard died from an asthma attack in 2001 while on holiday in Cyprus, at the age of 78.

The Girl Finally Gets Her New Heart!

I came across a piece of news last month (Oct 2007) learning that a young girl survived with two heart transplants. I then did some research through Internet and here is the information I had gather!

A young Malaysian Chinese girl, Tee Hui Yi, spent more than a year waiting for a heart donor finally fulfils her wish early this month (October 2007). But the operation did not go through smoothly. Her body rejected the first heart donated by a 15-year-old Muslim boy but fortunately, the second transplant using the heart of a 20-year-old Chinese man was successfully.

The 14-year-old girl was diagnosed with heart failure when she was just 2 years old, after a viral infection strike her. In order to keep her alive, she underwent an operation on 29 Sep last year was fitted last year with a mechanical heart. The mechanical heart is a device implanted outside her abdomen and connected to her heart. Because of this, she had to carry a battery weighing 9.8 kilos (about 20 pounds) to power the mechanical heart wherever she goes. The battery can only last for approximately 2 years. It is hope that this device can support her while awaiting for a donor.

A year has passed and yet no suitable donors for heart was found. Her deteriorating condition had really worried the doctors. Needless to say, she definitely felt very depressed. The girl had to make tearful pleas through the media for donors of heart.

"How long more do I have to wait for a heart? I need a donor soon."

This was the question that Hui Yi kept asking over and over again before she was given a chance to change her heart.

After the long wait of one year, she finally received a heart in a 10-hour operation at the National Heart Institute in Malaysia. The donor was an 15-year-old boy who died in a road accident. But, because of rejection, she had to undergo a second transplant 2 days later.

According to a report on 21 October 2007 by Bernama, the Malaysian National News Agency, Hui Yi is showing positive progress and in stable condition after she was taken off the ventilator a few days ago.

As a precaution to protect her from any infection, she was still placed in the Intensive Care Unit. Nevertheless, she could eat soup and porridge, and was fed supplementary nutrients through the tube in her nose.

After the operation, Hui Yi expressed her gratitude to all the people who had helped her for the past. Watch the following short video provided by eMedia:

Let us pray for her speedy discovery so that she can do many of the things that she wanted to do in the past but was not able to.

What happen to this young girl is certainly uncontrollable. But for healthy people like many of us, we should prevent heart disease from the outset. Remember, eat healthily and exercise regularly are still the keys to a heart healthy lifestyle.