John Ochsner Heart and Vascular Institute Performs Rare Double LVAD Surgery

The John Ochsner Heart and Vascular Institute (JOHVI) recently performed a groundbreaking double left ventricular assist device (BIVAD). Dr. Aditya Bansal was the surgeon for this life-saving procedure, directing a talented team of nurses and medical professionals throughout the nine-hour complex surgery.

The procedure used HeartMate 3™ LVADs, which received FDA approval in late 2017. In preparation for the procedure, the cardiac surgery team collaborated with surgical colleagues in Germany who recently performed the procedure using the same type of LVAD.

“Our team is incredibly proud to continue our legacy of innovation in healthcare and cardiothoracic surgery,” said Dr. Bansal, surgical director, Mechanical Assist Device Circulatory Support Program at JOHVI. “This cutting-edge procedure was the product of collaboration with international leaders in cardiothoracic care and utilization of the latest technology. As procedures and devices continue to evolve, we’re able to provide personal approaches to the millions of individuals facing heart failure.”

According to the Centers for Disease Control and Prevention, heart failure is a serious condition that affects approximately 5.7 million adults in the United States. The condition occurs when the heart muscle is unable to pump enough blood through to meet the body’s needs for blood and oxygen. The heart compensates for this issue by enlarging, developing more muscle mass and pumping faster. These temporary measures can mask the problem while heart failure worsens. Heart failure can affect the heart’s left side, right side or both, but frequently impacts the left side first.

Patients experiencing heart failure are considered for heart transplant, but may need additional surgical intervention if they are not candidates or are not healthy enough to await the gift of life. LVADs, also known as heart pumps, are used either as a “bridge to transplant” for patients awaiting a heart transplantation or “destination therapy” for patients who are not eligible for heart transplantation. LVADs are surgically implanted and attached to the heart; they are designed to assist with the pumping function of the failing ventricles. While LVAD therapy is becoming standard of care for advanced left ventricular heart failure, implanting the device on both sides of the heart is exceptionally rare.

“Our patients benefit exponentially by the spirit of collaboration; not only between our medical and surgical teams, but by our work with leaders across the globe,” said Dr. Sapna Desai, medical director, Mechanical Assist Device Circulatory Support Program at JOHVI. “Just as we don’t want our patients to feel limited by their diagnoses, our team isn’t limited to past approaches to care. We push ourselves to think differently to develop the treatments of tomorrow.”

Traditional surgical approach to treat patients experiencing failure of both ventricles may include implanting a total artificial heart (TAH) to provide full pumping capabilities to the entire heart. However, a TAH device tends to be bulky and may not always be compatible for a patient with a smaller chest cavity. In these cases, other solutions are explored, and utilizing two LVADs to serve as temporary support while waiting for a transplant can be a viable option. The HeartMate 3™ LVADs used in this procedure were small enough to fit the patient’s chest cavity, allowing the patient to return home once recovered from surgery.

“Our approach to patient care is focused on the individual patient,” added Dr. Bansal. “Rather than solely looking at past treatment plans, our team looks towards the future and explores ways to not only save lives, but preserve quality of life for our patients.”

The LVAD first received FDA approval in 1994 and was originally attached to a large, external power source. A more portable electric version received FDA approval the following year. The device has continued to evolve over the last two decades, becoming more compact and providing a longer-term heart failure solution to individuals who are ineligible for transplant.

This surgery is the latest accomplishment for JOHVI, which has been a regional and national leader in cardiology and cardiac surgery for decades. JOHVI performed its 500th LVAD and 950th heart transplant in 2017.

For the privacy and protection of those involved, no information will be released on the patient or their family at this time.