Artificial heart transplantation in Turkey by the most skilled heart surgeons, as this device takes over the function of pumping blood for some time, ensuring that the organs are supplied with oxygen and nutrients.
What is an artificial heart?
An artificial heart, or what is called a ventricular assist device (VAD), is a device that replaces the heart and can take over the function of pumping blood instead of the patient’s heart for some time. That is, it is an alternative system for the heart’s work that is installed to assist the natural heart. Therefore, an artificial heart can be used in severe cases where the patient’s heart is unable to supply the body with sufficient blood.
Currently, temporary artificial hearts are implanted to gain time while the heart is transferred from a donor. Most of those hearts are heart assist pumps, known in English as VAD (ventricular assist device).
The artificial heart should not be confused with the heart-lung machine, a larger device used during open-heart surgery, for example.
When is an artificial heart used?
A heart-lung machine is initially used to buy time during a heart transplant in a patient with severe heart disease.
A heart transplant is a last resort if medication and other procedures are no longer successful.
These patients are in the final stages of the disease, with a life expectancy of less than a year.
Also, when the heart’s pumping ability becomes so weak that the patient is at risk of dying in the short term, an artificial heart and heart can be used as a permanent replacement for the heart in severe cases (as a heart support pump).
There can also be severe conditions, such as heart failure, which require an artificial heart.
Heart failure can be caused by heart abnormalities, narrowing of the coronary arteries (CHD, coronary heart disease), or hypertrophic cardiomyopathies.
Sometimes, mechanical circulatory support is used to help the heart recover.
The goal is always that, at some point, the heart will be able to function on its own again.
How does an artificial heart work?
Generally, today’s artificial hearts are pumping systems that take over a large part of the heart’s production. That is, they are support pumps for the heart.
The artificial heart is called a VAD, which is an abbreviation for (ventricular assist device).
Most often, a left ventricular pump (LVAD) is used to supply the body’s circulation with sufficient blood.
However, there are also devices to support the right ventricle (RVAD), while those that ensure pulmonary blood flow to both ventricles are called (BVAD) for short.
The artificial heart is usually placed in the abdominal wall. The weakened natural heart also contributes to the pumping function.
The artificial pump is first connected to the heart and to the main artery (aorta) via plastic tubes.
If it is not an LVAD, it is connected to other parts of the heart and blood vessels accordingly.
The device moves blood from the heart chamber to the blood vessels and thus to the organs and tissues by means of a pump mechanism.
There are many other types, some of which have different pumping methods.
Some devices have a pulsating blood pump, and others have a continuous blood pump (e.g., with a small turbine). A battery powers the pump system.
It is controlled and monitored electronically. A cable runs through the skin and is connected to a control device.
In addition to these systems, there are also other variants, such as fully implantable artificial hearts, that lie entirely in the body.
They are only suitable for adults with large chests because they occupy a lot of body space.
A true heart replacement (TAH), i.e., a pump that resembles a human heart, is rarely used instead of the removed heart.
What tests are performed before an artificial heart is implanted?
Various medical tests are performed to diagnose heart diseases.
This includes a medical history and a physical examination.
It is also necessary to perform blood tests, blood pressure measurements, an electrocardiogram, long-term values, and imaging tests such as ultrasound and X-rays.
Further tests must be performed to place the patient on the waiting list for a heart transplant.
How is an artificial heart implanted?
An artificial heart is implanted under general anesthesia.
To access the heart, the chest and abdomen are opened. A pocket and opening for the cable are then created under the abdominal wall.
The heart-lung machine is connected to the circulatory system, supplying the body with oxygen-rich blood throughout the operation.
A hole is made in the heart chamber through which the feeding tube for the artificial heart system is inserted.
The heart is sewn around the tube, and a drainage tube is then placed in the main artery (aorta).
The pump is then inserted into the abdominal pocket. Once the artificial heart is turned on, the heart-lung machine can be disconnected. The chest and abdominal walls are closed again, and a bandage is applied to them.
Possible complications from surgery
A heart-lung machine can lead to serious complications. Primary bleeding, secondary bleeding, infection, and wound and scar healing disorders are possible.
Bleeding in the pericardium or infection in the body cavities can threaten life. The areas where the cables protrude from the body are also at risk of infection.
Blood clots can develop due to the implantation of the heart.
Vascular blockages can also occur, compromising the blood supply to the organs. However, the blood pumping technique fails very rarely.
After the operation
After the operation, the patient is transferred to the intensive care unit and then to the regular hospital ward. He receives appropriate physiotherapy until he can move normally and independently again.
The patient learns from the medical staff how to handle the artificial heart. He has to come to terms with the fact that he has to carry a monitoring device and a cable leading to the artificial heart with him outside the body. The patient must be very careful when washing and bathing, and the device must not come into contact with water. The cable in the skin can be wrapped. The patient is usually given anticoagulant medication.
After the hospital stay, the patient must go for regular check-ups, usually once a week.
Chances of success of the artificial heart
The heart pump improves the blood flow in the body and thus ensures that the organs are adequately supplied with oxygen and nutrients.
The heart muscle will not have to pump as hard and will be much more relaxed.
However, although more than one patient has lived with the device for several years, the artificial heart cannot be a good substitute for the human heart in the long run.
It is possible that blood pumps and the treatments associated with them will be better developed in the future. Then, a heart transplant can be dispensed.
Artificial heart operations are usually performed when other organs are damaged due to the weakness of the heart (such as the kidneys). Therefore, the surgical risks are higher compared to operations performed on healthy patients.
It often takes longer than usual for patients to recover from the operation.
The process of getting used to the artificial heart often lasts for weeks.
The patient can spend a large part of the time at home and, to some extent, do normal activities (housework, walking, cycling, work).
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