Re: LVAD or Dor

Posted By Q. Grant on July 26, 1999 at 09:49:34
Twenty years ago I graduated BSc with majors in Physiology, Biochemistry and Genetics. I am now 46 and a serious sufferer of CHF caused by a clott in a circumflex stent. My Pulmonary artery pressure is 70/31 with a mean of 45 but pulmonary vascular resistance is low at 1.97. There is significant impared left ventricular function. All my arteries are now clear and the stents are open and have been so for over six months. This is unlikely to change.
I self mediate (and run graphs of H/R B/P and weight gain/loss) under close liason with a wonderfull cardiologist Dr Jane Somerville. The area, however that she can not advise upon is the choice between Transplant which she recomends (She is worried about renal failure due to the fact that I need up to 240mg of fruzamide per day plus 25mg captopril and 0.125mg digoxin to keep the fluid retention at bay), Dor, or LVAD which I prefer in view of the fact that I react very badly to all drugs and stem cell research seem so close to being able to provide a solution. Also I am (or was six months ago) very fit and active, and there is no problem with the right side of my heart at all.
With regard to LVAD I saw a program recently on a LVAD which was developed in conjunction with NASA and a very emenant cardioogist who is now over 90 years old. The LVAD consisted of an impellor pump located in a stainless steel housing. I can find no reference to this on the net. Do you know of this system.  The thought of living like the chrocodile in Peter Pan with a loud clanking device is not on.
Thanks for your time
QG

[CF-CARDIO-MD-JMF]

Posted By CCF CARDIO MD JMF on July 26, 1999 at 14:41:39
Dear Q. Grant,
An LVAD is a left ventricular assist device that is used to assist the left ventricle improve its function.  It is often used here in Cleveland to bridge a patient to transplant.  It consists of a surgically implanted device placed in the apex of the heart and a pump that circulates blood.  
The Dor procedure is a left ventricular remodelling surgery that can be used to remodel a scarred, deformed ventricle in an attempt to improve hemodynamics.  This procedure is also done at the Cleveland Clinic.  You might consider a second opinion regarding your options for heart transplant versus some of these other issues.  Your pulmonary pressures are increasing and you certainly would not want to miss your window of opportunity for consideration for any of these options.
Cleveland Clinic performed the most heart transplants in the united states last year (over 120) and has access to many of the new left ventricular assist devices on the market as well as surgeons familiar in ventricular remodelling surgery.  I would suggest a second opinion to review the specific details of your case. The cardiac surgeons who typically consult regarding heart transplant and/or devices are Dr.  Patrick McCarthy and Dr. Nicholas Smedeira.
I hope this has been useful. I wish you the best of luck. Feel free to write back.
Information provided here is for general purposes only. Specific questions should be addressed to your own doctor.
If you
would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter. The Heart Center website contains a directory of the cardiology
staff that can be used to select the physician best suited to address your cardiac problem.

[Q-Grant]

Posted By Q. Grant on July 28, 1999 at 06:08:40
Thank you for your response: I will be having a meeting with Prof. Yacoub in a few days and we wll be discussing the three possibilities: At some stage I will be making a decision and the only good decision is an informed decision.
Can you answer the following:
1: How soon will Homogenous Heart tissue and hearts be developed from stem cells.
2: What tests can be regularly conducted on urine to detect signs of renal failure: Protinurea?
3:Is it possible to set up an online consultation with your surgeons given that a suitable financial arrangement can be found and that I am resident in Ascot England.










Follow Ups:


Re: LVAD or Dor CCF CARDIO MD JMF 7/29/1999
(2)

LVAD or Dor Q. Grant 8/01/1999
(1)

Re: LVAD or Dor Troy 8/02/1999
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