The McGill University Health Centre (MUHC) is proud to announce that it has performed Canada's first heart pump implant for long-term support of patients with heart failure. Dr. Renzo Cecere, Surgical Director of the MUHC's Royal Victoria Hospital site's Centre of Heart Failure and Heart Transplant installed a LVAS (left ventricular assist system) in a 61-year old patient in mid-February.
"It is like night and day. Prior to the operation the patient had a very poor quality of life. He could barely leave his home," said Dr. Renzo Cecere. "Today he feels great."
The MUHC's Royal Victoria Hospital site is participating in a Health Canada approved investigational study, entitled INTrEPID to test long-term use of World Heart Corporation's Novacor® LVAS in patients suffering from heart failure who are not eligible for transplant. Health Canada has authorized the MUHC to implant five LVAS devices for long-term use. A LVAS is an electronically powered pump that provides circulatory support by taking over most of the workload of the left ventricle of the heart.
Currently, Health Canada has only approved the use of LVAS in patients with end-stage heart failure who are waiting for heart transplant operations. To date the MUHC has implanted 16 LAVSs as bridges to transplant.
"This is a potential revolution in the management of end-stage heart failure. Many patients are ineligible for heart transplant operations and there were no long-term alternatives for their survival," said Dr. Cecere. "Now, based on the bridge to transplant experience, we believe we can offer these patients a higher quality of life and prolonged survival with a long-term left ventricular assist system."
Some 3000-4000 Canadians with end-stage heart failure could benefit from heart transplants, but only 200 hearts are available each year. In Quebec, 40 transplants are performed each year, and it is estimated that additional 100 to 150 patients could benefit from an alternative therapy, such as a long-term LVAS. Patients become ineligible for transplants because of co-existent diseases like diabetes or because of other conditions that make it difficult to find a suitable heart.
"The limiting factor is how we will pay for these life saving procedures," said Dr. Cecere. "The government has to address the issue of funding."
Each LVAS operation costs approximately $100,000. The option of left ventricular assist system, as a bridge to transplant is becoming a standard of care in the management of some patients with end-stage heart disease. The Quebec Ministry of Health is considering supporting this approach.
While it is too early to compile statistical data, Dr. Cecere believes that in the long run LVAS implants could save the health care system money because patients with heart failure would require fewer hospital admissions.
"I'm extremely optimistic. We are in a transition period," said Dr. Cecere. "We've learned a lot from bridge to transplant procedures and now we are looking at the viability of long term use. This will all lead to better and better heart pumps, which are smaller, quieter and more comfortable."
Physicians who have patients they would like to refer to the Trial should contact the Canadian INTrEPID Trial Information Line at (613) 226-4278, ext: 2002.