The surgeons of Almazov Centre performed a rare surgery in a young man to implant a new-generation domestic ventricular assist device designed for long-term mechanical support of the left ventricle.
A 35-year-old man from Kaliningrad was admitted to Almazov Centre in October 2018 with decompensated chronic heart failure on the background of dilated cardiomyopathy – the impaired contractile function of the heart muscle (myocardium) with marked dilatation of heart chambers. According to statistics, only 30% of patients with this disease survive the first five years…
The Centre’s team decided that heart should be transplanted after stabilization of the patient’s condition. In order to compensate heart failure and prepare the patient for the upcoming surgery, they jointly chose the optimal treatment strategy and specialized therapy. The patient was treated by the cardiologist O. Yaznevich under the supervision of M. Bortsova, head of Cardiology Department No. 8, and I. Orazmagomedova, head of Anesthesiology Department with ICU No. 8, jointly with P. Fedotov, head of Research Laboratory of High-Tech Treatment Methods for Heart Failure, Prof. M. Sitnikova, Head of Heart Failure Research Department, and O. Moiseeva, MD, DSc, Director of Heart and Vessels Institute.
Prof. M. Gordeev implanted the system
To correct the parameters of central hemodynamics in case of severely impaired systolic function, the first step was to implant the extracorporeal membrane oxygenation system (ECMO) with left ventricular bypass. In fact, ECMO is similar to cardiopulmonary bypass, but it is with minimally invasive access through femoral arteries and veins. The life-saving surgery was performed by D. Zverev, head of Interventional Surgery Research Laboratory. Postoperative treatment and follow-up were under the supervision of A. Maricheva, head of Anesthesiology Department with ICU No. 7, and A. Bautina, head of Anesthesiology Research Laboratory.
Doctors used ECMO as a temporary measure to stabilize the patient and make a decision on further treatment: waiting for a donor heart or implanting an “artificial” one.
STREAM CARDIO device
They chose the second option — to implant the new-generation domestic LVAD for long-term support, STREAM CARDIO. In late December 2018, prof. M. Gordeev, director of Cardiac Surgery Clinic, together with cardiac surgeons from Sklifosovsky Research Institute for Emergency Medicine and specialists of device manufacturers performed a very complex surgery to implant the device.
The successful surgery gives the patient a chance to survive until a donor heart becomes available for transplant. The man is recovering, and his physical activity has slightly increased for the first time in a long time.