The same technology that allows bullet trains to travel at speeds of 200 miles per hour without touching the rails will continue to keep our currently malfunctioning hearts beating. And in the near future, we’ll be able to keep our hearts beating via wireless power connections. Mandeep R. Mehra, MD, FRCP, today discussed cutting-edge heart pumps and other advances in mechanical circulatory support (MCS) at the International Society for Heart and Lung Transplantation (ISHLT) Annual Meeting and Scientific Sessions in Prague. did.

Over the past 30 years, advances in the field of mechanical circulatory support have been extremely difficult to achieve. But we are now at a point where surgically implanted devices are moving from saving patients on the brink of death to providing long-term treatment, prolonging survival, and providing functional capacity. . ”

Dr. Mandeep R. Mehra, Executive Director, Center for Advanced Cardiology, Brigham Health, Boston

MCS devices are temporarily or permanently implanted in patients with advanced heart failure to keep the heart pumping enough blood. Dr. Mehra compared the generational change in MCS devices to the evolution of automotive technology.

“I think we went from the Model T Ford to Mercedes-Benz and BMW,” he said. “Now we need to move on to Porsche and Ferrari.”

Early MCS devices mimicked human heart function. It was large, bulky, heavy, and had multiple moving parts that could fail. The next generation of devices, small non-pulsating continuous flow pumps, are small but carry the risk of bleeding from mucosal sites such as the intestines.

“These devices require a power line that exits the patient’s abdomen and connects to an external battery,” he said. “So patients using this pump live longer and have better functional abilities, but they are still tethered to a battery.”

The latest development in MCS devices, magnetically levitated centrifugal flow pumps, prevent clotting and reduce bleeding and other complications inherent in earlier devices. It has a motor and a rotating disc suspended entirely within a magnetic field, and works on the same “maglev” principle used in high-speed trains. Frictionless pumps with no mechanical bearings and a wider passage for blood flow generate artificial pulses by rapidly changing rotor speed.

Dr. Mehra said patients with left ventricular assist devices (LVADs) designed with this technology are now surviving for more than five years, with survival rates comparable to those of many heart transplant patients.

“MCS devices are much more forgiving at this point,” he said. “But we need to move to an era where they are forgotten.”

State-of-the-art magnetic levitation heart pumps have been implanted in well over 10,000 patients to date, and further advances such as further miniaturization and fewer peripheral components could increase that number tenfold. Dr. Mehra said that there is.

“Within the next five years, new pumps will have completely internal power lines and be powered wirelessly from outside the body, much like an iPhone,” he said. “Once these devices are implanted, patients will be able to forget about them.”

During his presentation, Dr. Mehra also reported on other advances that have revolutionized the field, including xenografts and bacteriostatic, biocompatible surfaces that minimize infection.

“We have the potential to serve even more heart failure patients, extend their lives and, importantly, extend their lives,” he said. “The scalable impact is huge, and we’re just scratching the surface right now. Within the next five to seven years, unnecessary patient deaths will be a thing of the past.”