Device for assisting cardiac function

Details Device for assisting cardiac function Device for assisting cardiac function

1995-11-22

1998-12-15

Lacyk, John P.

Surgery

Cardiac augmentation

600 17, A61N 1362

Patent

active

058489622

DESCRIPTION:

BRIEF SUMMARY
BACKGROUND OF THE INVENTION

1. Technical Field
The present invention relates to a device for assisting the function of the myocardium.
2. State of the Art
When the heart fails to pump, the cause is a muscle weakness of the left ventricle due to which the heart cannot eject sufficient blood volume into the aorta as a consequence of which maintaining circulation is no longer ensured. The reasons for the heart to fail to pump are manifold; to name some examples: virus disease, reduced blood circulation in the myocardium, pumping failure following heart surgery, etc.
Hitherto approaches in treatment of this usually fatal cardiac dysfunction are system in place of the left ventricle, ultimately these developments end with the so-called artificial heart.
Medicine can only be used to control cardiac pumping failure if the damage is temporary, because these strong medicines can only be utilized for short periods due to their major side-effects. In particular, however, these medicines can only be employed in minor pumping failure, because only myocardium assistance can be achieved and even medication will not make a manifestly no longer contracting muscle do so. The increase in cardiac performance is only approximately 15%.
Intra-aortic balloon counter pulsation, also called IABP, which was introduced in 1968, is a method in which a balloon catheder is entered into the aorta. Rhythmic inflation and deflation of the balloon increases the diastolic blood flow in the coronary vessels of the heart; the increased supply of blood and the improved blood circulation in the myocardium raises the pump function of the left ventricle. An improvement of approximately 10% to 20% can be achieved with this method. The drawbacks of this method are first only minimal improvement of myocardial pump function, secondly the possibility of complications, mostly bleeding and vessel obstruction. Moreover, as there is a foreign matter in a corporal vessel, the blood has to be prevented from coagulating.
Another approach are heart transplants. According to the reports of the German Association of Thorax-Heart and Vessel Surgery, the number of transplants in Germany has remained relatively constant since 1991. The reason for this ought to be the lack of heart donars. However, the number of patients waiting for a transplant is increasing by approximately 10% annually, without this problem having been solved.
In particular, however, usually only patients with chronic pump failure can be considered for a heart transplant, temporary failure can practically not be treated with this method.
Further disadvantages of heart transplants are the high costs of material and personnel. Moreover, transplant patients have to submit to immune suppression for the rest of their lives, resulting in increased susceptibility to infection. In addition, frequent inpatient treatment to check the implanted organ is required, which is very time and cost consuming.
Finally, now that this method has been established in hospitals for a number of years, it is known that due to the transplant rejection and arteriosclerotic changes in the coronary vessels of the transplanted organs, only unsatisfying long-term results can be achieved. Moreover, the occurence of tumors increases in these patients (i.e., due to immune suppression|).
The so-called muscle ventricles are a surgical procedure in which the large dorsal muscle is lifted and removed and then inserted into the thorax and wrapped around the heart. This dorsal muscle is previously induced by electric instruments to beat permanently which is said to alter the muscle fibers. After this dorsal muscle has been wrapped around the heart and sutured, and it contracts rhythmically, the heart is compressed and thereby the output volume of ejected blood is increased. This approach, which is still in the experimental stage, also has a great number of disadvantages:
1. At this time, it has not been possible to completely and, in particular, not for a sufficient period of time, convert the muscle fibers by means of electric pulses.

REFERENCES:
patent: 4690134 (1987-09-01), Snyders
patent: 5131905 (1992-07-01), Grooters
patent: 5569156 (1996-10-01), Mussivand

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