How to Wear Your HeartMate II Lifelines
It is 6 a.m. and your alarm clock sounds. While you roll over in bed to hit the snooze button, you can feel the tangling of the wires from your HeartMate II. You suddenly bounce awake, not by your alarm clock, but by the insecure feeling of the lifelines of your HeartMate II dangling vulnerably. As you get up, you hold the system controller firmly and inconveniently in your hand, handicapping you with only one hand functional. The mechanical system is fragile, and you do not want to drop any piece but there is no place to securely place the system.
What is the HeartMate II and the Evidence Behind it?
End-stage heart failure refractory to pharmacological treatments requires a cardiac transplant. A left ventricular assist device (LVAD) offer two lifesaving options for patients waiting for a transplant – a temporarily bridging therapy or permanently as a cardiac replacement therapy for those ineligible for a transplant.
The HeartMate II is a continuous-flow pump that utilizes a rotary blade. The rotary system has an implant volume of 63mL and generates up to 10 liters of flow per minute at a mean pressure of 100 mmHg. The internal pump is controlled and powered by an external system controller and battery pack via a percutaneous lead.
Dr. Miller and colleagues from the University of Minnesota, Minneapolis, conducted a study in 2007 to evaluate the HeartMate as a bridging therapy. The investigators demonstrated very positive outcomes with 75% of patients successfully bridged to a cardiac transplant within 180 days.1 In 2009, Dr. Slaughter and colleagues from the Advocate Christ Medical Center, Illinois, furthermore demonstrated those who use the HeartMate II permanently had a survival benefit compared to conventional pulsatile-flow LVADs. 2 The HeartMate II is therefore a reliable LVAD with an established track record.
Real-life Challenges to Living with a Lifeline
While the HeartMate II is a revolutionary life-sustaining therapy, the challenges of living with lifelines, battery packs, and a system controller is inconvenient, insecure, and a constant reminder to patients of the mechanical dependency of their life. It handicaps a patient and the sight of the mechanical nature of the HeartMate II can be disturbing to some.
Carew Medial Wear (www.carewmedicalwear.com) is a patient-centered integration of the HeartMate II mechanical components seamlessly into an everyday LVAD vest or clothing. Carew Medical Wear has integrated secure housing for each mechanical components (i.e. batteries, drive line, system controller), thereby freeing you the mental burden of being cognisant of the fragile system. Each component of the HeartMate II is effortlessly and securely stowed into a housing pocket in the LVAD vest/wear.
The HeartMate II is an incredible piece of technology by sustaining life in end-stage heart failure. The practical challenges of wearing the HeartMate II can be a cumbersome and insecure experience. Carew Medical Wear seamlessly integrates the external mechanical components of the HeartMate II into your everyday garment so you can enjoy your everyday activities without being disabled by your very own lifelines.
(1) Miller LW, Pagani FD, Russell SD et al. Use of a continuous-flow device in patients awaiting heart transplantation. N Engl J Med. 2007;357(9):885-96.
(2) Slaughter MS, Rogers JG, Milano CA et al. Advanced heart failure treated with continuous-flow left ventricular assist device. N Engl J Med. 2009;361(23):2241-51.