Artificial hearts don’t miss a beat

2016-09-27 06:00

Artificial cardiac device implantation is increasingly replacing donor heart transplantation in South Africa and around the world, and is likely to totally replace it within the next 10 to 15 years.

Dr Willie Koen, an internationally renowned cardiac and transplant surgeon who practises at Netcare Christiaan Barnard Memorial Hospital, says: “Mechanical heart device implantation is reaching new levels of maturity internationally, to the extent that it already takes place twice as often as biological heart transplants,” he says. “Mechanical heart implantation is changing the face of heart medicine and is resulting in a revolution in the field of cardiac replacement.”

Koen recently addressed the 26th World Congress of the World Society of Cardiothoracic Surgeons on this topic. “Mechanical implants do not as yet have the same longevity for the patient as the biological option, but can support a patient for between six to eight years. We expect this to improve as artificial devices are undergoing rapid development, and there is little doubt that within the next decade or so they will have the longevity of the biological option which is 20 years or more.”

Mechanical implantation holds a number of advantages over biological heart transplantation, Koen says.

“Unlike donor hearts the mechanical devices are readily available. Patients therefore do not have to wait on the transplant waiting list for a matching donor heart as, tragically, many patients run out of time and die before a matching heart can be found for them.

“The mechanical devices require no anti-rejection drugs which often cause side effects in patients. And, while the artificial hearts are currently relatively expensive, they obviate the need to take costly drugs. Over the longer term therefore mechanical implantation is cost-effective, the saving on anti-rejection drugs making up the cost difference within a period of five years. He adds that patients that are implanted with a mechanical heart can have a normal quality of life, with their greatest inconvenience that the batteries need to be changed.

According to Koen, mechanical heart technology evolved at the same time as heart transplantation in early 1960s. Transplantation, however, tended to dominate over the following 45 years. Two approaches to transplantation developed: there were those who continued with biological transplant research, while other groups in the United States and Europe undertook research into mechanical implantation.

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