Implantation of JARVIK in IKEM
On Thursday 23rd August our IRC Division supported the implantation of long-term left ventricular assist device JARVIK 2000 in Institute of Clinical and Experimental Medicine (IKEM). JARVIK is a unique heart pump that supports the circulation in patients whose left ventricle is in the terminal stage of heart failure and can take over the function of the left ventricle in case of its complete failure. Thus, the patients with practically unfunctional pumping function of the heart have a chance to survive. The heart assist device JARVIK 2000 is certified to secure the patients until a suitable donor is found for transplantation; however, it could serve as a destination therapy for the rest of patient’s life. In a small percent of cases the heart function recoveries during mechanical support so that the patient’s heart can sufficiently perform its pumping function and the mechanical support is no longer necessary.
PROMEDICA PRAHA GROUP, a.s. is the only company in the Czech Republic, that offers a heart assist device with a power cable connected behind the ear (postauricularly) into an implanted connector. Compared to the competitors whose power cable leads to the abdominal region, this concept has the benefit of lower infection rate in the outlet site. Also, the lower mechanical stress of the power cable leads to a minimal risk of cable damage. Moreover, the postauricular cable allows the patients to swim and sink under the water.
The whole surgery was unique and required thorough preparations. Regarding the worsening conditions of the patient, there were only five days left for the preparation, including the weekend. Our division provided the supply of the assist device itself and the instruments required for the implantation. We also provided the expert support for the operation team by the presence of a proctor Professor MD. Massimo Masseti from Rome, the head of the cardiovascular centre of the University Polyclinic Agostino Gemelli, and of a representative of JARVIK company Dave Thomas from the United States, the sales manager of JARVIK company.
A thorough training of the medical personnel preceded the surgery; not only of the operation theatre personnel, but also of the nurses and physicians, who are currently taking care of the patient in cardiosurgical resuscitation unit, those who are going to take care of the patient in a cardiosurgical ICU and the personnel who will discharge the patient home and who will follow up during outpatient care.
The surgery started on Thursday at 8 a.m. by getting the patient ready in the operation theatre. The procedure itself started at 9 a.m. Four surgeons were working on the patient at the same time. In one moment, the connector attached to the skull was being prepared and simultaneously the patient was attached to the extracorporeal circulation. Subsequently the thoracic access and the heart access for implantation was prepared. The preparations took about one hour. The assist device was prepared and tested before implantation, afterwards it was implanted and sewed for next 45 minutes. Closing the operation wound, disconnecting the patient from the extracorporeal circulation and setting the parameters of JARVIK took the rest of the time. After 3.5 hours the patient was taken to cardiosurgical resuscitation unit.
The surgery was performed by Professor MD. Ivan Netuka, Ph.D., the director of the Cardiovascular surgery department and Associate Professor MD. Jiří Malý, Ph.D., the Deputy director for science and research head of the Operating theatres with his assistants under the leadership of Professor Massimo Masseti. Apart from the surgeons, there were other staff members present in the operation theatre, without whom it would not be possible to perform the surgery – the anaesthesiologists, the perfusionists, the echocardiographists, scrub nurses and theatre nurses.
One day after the surgery, the patient was woken up from anaesthesia, extubated and detached from the mechanical ventilation. His condition is getting better currently. We believe that JARVIK 2000 will provide him the support for his full life.
Interventional Radiology and Cardiology Division
