Cardiac surgeons use new, minimally invasive surgery to implant heart pump

For immediate release: January 31, 2014

Procedure enhances patient safety at the University of Maryland Heart and Vascular Center

LVAD minimally invasive OR shot LARGE

Click the image to watch video from the operating room.

In a new procedure designed to expedite patient recovery, cardiac surgeons at the University of Maryland Heart and Vascular Center have implanted a ventricular assist device using a minimally invasive technique that employs small openings in the chest, a patient-friendly approach that provides the same results as traditional chest-splitting, open-heart surgery for heart pump implantation.

For the patient, the new technique means quicker recovery, reduced chance of infection and minimal blood loss. This minimally invasive approach also reduces the chance of scarring around the heart, a side effect of open heart surgery. When it comes time to do a heart transplant, surgeons always employ an open chest procedure to remove the damaged heart and connect the large blood vessels entering and leaving the new heart. The scar tissue can prolong and complicate the removal of the damaged organ.

“Minimally invasive surgery for implantation of a ventricular assist device is more difficult to perform than the standard open-heart approach,” says Si M. Pham, MD, professor of surgery at the University of Maryland School of Medicine and director of heart and lung transplantation and the artificial devices program at the University of Maryland Medical Center. “But there are many benefits for patients who are eligible to have this kind of surgery while they await a heart transplant.”

University of Maryland cardiothoracic surgeons have led the development of ways to operate in a closed chest, perfecting minimally invasive versions of other common surgeries, including coronary bypass surgery and heart valve procedures, once done as open-heart operations. “Applying a minimally invasive approach to ventricular assist device implantation continues our tradition of innovation and enhanced patient care,” says Dr. Pham.

A ventricular assist device (VAD) can be used as a temporary bridge to transplant for patients with heart failure who are too ill to survive while they await a new heart.

Sixty-nine-year-old Walter G. Amprey, EdD, from Finksburg, Md., is believed to be the first person in Maryland to benefit from the new surgery. Surgeons implanted a miniaturized VAD in the left ventricle of Dr. Amprey, a former superintendent of public instruction for the Baltimore City Public Schools, on December 17, 2013.

For a decade, Dr. Amprey has battled heart failure, in which the heart muscle cannot pump enough blood to meet the body’s need for blood and oxygen. Several years ago, a pacemaker was implanted to correct an irregular heartbeat.

Medications and expert treatment from a team of University of Maryland Heart and Vascular Center cardiologists helped Dr. Amprey maintain an active life for many years. Recently, however, his condition deteriorated. A week before the VAD implant, while driving his car on the Baltimore beltway, he felt dizzy and lost consciousness as his car rolled down an embankment hitting a tree. “All I remember is hearing my wife, Andrea, in the passenger seat, calling out to me to stay with her,” says Dr. Amprey. His heart had stopped beating for 24 seconds.

Dr. Amprey was placed on the heart transplant waiting list, but his doctors feared he would not survive the wait without mechanical assistance to supplement his heart’s pumping ability. Since the VAD implantation, Dr. Amprey says there has been a gradual improvement. Plus, the minimally invasive nature of his surgery is a bonus: “I’m glad I did not have to undergo the traditional surgery to benefit from the VAD,” says Dr. Amprey.