Mechanical support for heart failure
"The maintenance of an adequate blood pressure, thanks to the ventricular assistance, allows a correct perfusion of the vital organs, making possible their functioning and avoiding the multiorgan failure".
DR. GREGORIO RÁBAGO JUAN-ARACIL DIRECTOR. CARDIAC SURGERY DEPARTMENT
What is mechanical cardiac assistance?
Mechanical assistance, also called circulatory or ventricular assistance, consists of a series of mechanical devices.
These devices are composed of a hydraulic propulsion system that, connected to the circulatory system, are capable of replacing heart function temporarily or permanently.
At the Clinica Universidad de Navarra, we have a team made up of surgeons, anesthesiologists, hematologists, infectious disease specialists, and a team of nurses who are highly specialized in the handling of these devices, and who in a coordinated manner control these patients daily until they are discharged and then in their homes.
When is ventricular assistance indicated?
These devices have the mission of replacing the function of the heart, partially or totally, by recovering the blood before it reaches the ventricles (left or right) and pumping it to the arteries that come out of them: the aorta (in the case of left ventricular assistance) or the pulmonary artery (in the case of right ventricular assistance).
The type of flow generated by these pumps depends on the model, and can be pulsatile (similar to the heartbeat) or continuous (in these cases there is no pulse wave). The duration of the support may vary depending on the case and the indication between days, months or years.
Learn about the HeartMate II Ventricular Assist Device (available in spanish)
Most frequent indication for mechanical assistance
Do you have a worsening of your heart failure?
You may need a ventricular assist device
Learn more about ventricular assistants
Types of devices
Depending on the intention of the implantation, we could classify the ventricular assist devices in three main groups:
Helps the recovery of heart function
There are special circumstances, usually acute situations (acute myocardial infarction, myocarditis, after complex heart surgery) in which the heart suffers sudden damage with a temporary loss of its normal ability to function. Once full recovery is obtained, the assist device can be removed.
Bridge to heart transplantation
Sometimes, patients on the waiting list for heart transplants present a progressive deterioration that does not respond to medical pharmacological treatment and the unavailability of a suitable heart at that time implies a significant vital risk.
Mechanical assistance
Allows these patients waiting for a heart to improve their circulatory situation, gaining the necessary time until a suitable donor emerges and the transplant can be performed.
Definitive therapy
Finally, there are groups of patients who are not candidates for heart transplants, in which the only possible therapeutic option is the implantation of a permanent assist device, which enables them to maintain a correct circulatory function, and to be discharged with the assist device implanted in their body, requiring periodic controls and a specific treatment.
Treatment duration
Everything depends on the indication with which the mechanical assistance was implanted. If the intention was to recover the damaged ventricle, the average assistance time varies between a few days and several weeks, after which, once the ventricular function has been recovered, the ventricular assistance device is removed.
If the implant was performed in a patient on a waiting list for heart transplantation, the assist is removed at the time of transplantation. Normally, this last group of patients are on the assist for a few months, depending on the time needed to find a suitable organ.
Finally, in those cases in which the implant is carried out permanently (definitive assistance), the patient is discharged with the device, having to follow periodic controls with his medical team.
Where do we do it?
IN NAVARRE
The Department of Cardiac Surgery
of the Clínica Universidad de Navarra
The Cardiac Surgery Department of the Clinic is backed by its extensive experience of more than 50 years. It is a pioneer in the introduction of the most complex procedures and the most avant-garde techniques.
Our surgeons are specialists trained in international reference centers, which combine the application of the latest techniques with personalized treatment to our patients.
We also have a team of highly specialized nurses, both in surgical and clinical aspects.
Treatments we perform
- Coronary surgery
- Valve surgery
- Thoracic aortic surgery
- Atrial Fibrillation Surgery
- Heart failure surgery
- Heart transplantation
Why at the Clinica?
- Pioneers in advanced procedures and techniques.
- Implantation of the first total artificial heart in Spain in 2016.
- Specialists trained in international centers of reference at national level.
