In 1995, Jean Loken’s health was deteriorating quickly.Within days of suffering a highly damaging heart attack, she learned that she’d need a new heart to survive.
Finding a donor organ for transplantation would likely take months that Loken did not have. So her doctors at the University of Minnesota Medical Center did the next best thing—they implanted into Loken’s failing heart a ventricular assist device (VAD), which could keep blood pumping in and out of the organ until a new heart became available. That day, Loken became the first person to be implanted with a VAD in Minnesota.
Three months later, Loken had her transplant. Her new heart has been pumping strong ever since.
Loken is one of more than 350 people who have benefited from the University’s expertise in VADs. About 5 million people in the United States have heart failure, and in severe cases, treatment considerations can become a race against time. While heart transplantation is often the best treatment for end-stage heart failure, a paucity of heart donors—particularly in the Midwest—makes that option often impractical or even impossible.
“Here, finding a [heart for] transplant can take as long as 12 months,” says Kenneth Liao, M.D., Ph.D., surgical director of the University’s heart transplant program and associate professor of surgery. “Most patients with severe heart failure would die if they had to wait that long.”
Enter the University’s VAD program. VADs, mechanical devices that can replace the pumping action of a failing heart, can keep a patient stable until a transplantable organ is available (which doctors call “bridge to transplant”), supported until the heart heals on its own (“bridge to recovery”), or alive long-term if a transplant is not possible (“destination therapy”).
People who have received VADs at the University electively have a 96 percent chance of survival—well above the national average of 85 percent.
“We continue to be a top VAD program in the world because we select the appropriate patients for VAD at the optimal time, then give them the appropriate device and treat them appropriately,” says cardiologist and associate professor of medicine Andrew Boyle, M.D.
Patients here often have access to new, improved devices first through clinical trials.
A University team took part in a national trial finding that the HeartMate II® device could safely and effectively be used as a bridge to transplant. About 84 percent of participants receiving the device, which got Food and Drug Administration (FDA) approval for this use in April 2008, survived until transplantation or were discharged from the hospital.
Another University-led trial evaluated the use of the VentrAssist® device for the same purpose. After six months, 86 percent of the patients enrolled in the trial received a heart transplant or were alive on device support. The VentrAssist is now awaiting FDA approval.
Ranjit John, M.D., the University’s VAD program director, says devices such as the HeartMate II and VentrAssist are the future of VADs. “They are smaller, much more durable, much more reliable, and they represent the next generation of pumps,” he says.
Loken says she’s thankful that she is among hundreds of lucky people to have received a VAD at the University. She now walks a brisk two miles every day, plays with her grandchildren, and enjoys volunteering for transplant groups.
“I’ve competed in the Transplant Games, I traveled to Europe… I sew,” says Loken. “I can do every activity that a 64-year-old would want to do.”