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World gathers in Edmonton

September 16, 2010

Mazankowski invites specialists to share expertise on rare cardiac procedure

More than 200 cardiac specialists from around the world gathered at the Mazankowski Alberta Heart Institute in Edmonton this week for the first international meeting to discuss a life-extending cardiac technology.

Ventricular assist devices, or VADs, are battery-powered, mechanical circulatory devices that assist the right and/or left ventricle of the heart to pump blood in patients experiencing heart failure.

Short-term VADs can be used for a few days or weeks until a more permanent solution – a heart transplant – is possible. (A VAD would be removed once it is no longer required.)

Long-term VADs can be used for up to 10 years in patients who, for various reasons, are unable to have a heart transplant.

“VADs are used to treat the sickest of the sick. They are used for patients for whom recovery is uncertain and the transplant list might not be a possibility,” says Dr. Holger Buchholz, director of Pediatric and Adult Artificial Heart programs at the Mazankowski Alberta Heart Institute, and one of the event’s organizers.

For 20-year-old Ian Hauck, a VAD was just what he needed.

He was admitted to the Mazankowski in February with heart failure. A virus had attacked his heart and he was too weak and sick to be a candidate for a heart transplant.

Hauck has Down syndrome, so his family gathered to make a decision about his care. His mother, Kathy, says there was only one choice.

“It was a really tough time but it was wonderful to know there was an option. Where he was at that point in time, it was our best hope,” she says of the decision to install a short-term VAD.
The device assisted Hauck’s heart and supported the rest of his organs while his body recuperated. His condition improved enough that he underwent another procedure to have a long-term VAD installed.

After a six-month hospital stay, Hauck is back at home in Wainwright.

“I’m just happy he’s here,” said Kathy. “He’s happy he’s here.”

Major cardiac centres treat only a small number of VAD cases every year – the Mazankowski treats about 30 patients annually – which limits the amount of information that is available for research.
Buchholz says specialists were attracted to the opportunity to share and pool the limited knowledge that currently exists in this relatively new field. (The first generation of VADs was introduced in 1994.) Alberta Health Services is considered a Canadian leader in the field, he says.

The two-day event drew specialists from across Canada, the U.S., Europe, Asia and South America. Experts discussed experiences ranging from surgical techniques, post-operative management, patient selection and the extreme challenges presented by treating medically fragile patients.

“A VAD is a bridge device. In some cases, it might be a bridge to recovery. It might be a bridge to transplant. Ultimately, VADs give you time – time to make the right decision, both for the medical team and the family,” says Buchholz.

“The more we refine treatment and care, the better the outcomes will be for patients.”