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Sunday, 22 December 2013

First test of new French artificial implantable heart

A first patient has been fitted with a new French artificial heart
Watch interview on @AJEnglish:  
Heart failure is one of the commonest causes of urgent admission to hospital. Modern drugs – and their effective use in combination - have dramatically improved treatment of heart failure. However in many patients heart failure is a progressive disorder and perhaps 100,000 patients in USA and Europe alone are candidates for a new heart. Conventional organ transplantation is limited by availability of a donor heart, the complexity of immunosuppression and other major risks of the procedure.

The dual ambition of the company behind this new technology is an implantable heart which will both allow return to good quality of life for at least 5 years, and be subject to a lower risk of serious complications then earlier devices.

Implanting an artificial heart while awaiting a heart transplant is not a new idea. The first sustained success was for the Jarvik device, first used over 30 years ago. And current implantable devices have been reported to be successful for almost 4 years.

The new Carmat heart is lined with a combination of synthetic polymers and treated tissues from the heart sac (pericardium) of the cow. This aims to reduce the chance of blood clotting on the internal lining of the heart – an important potential risk from an artificial heart. And partnership with aerospace engineers has lead to new biofeedback sensors in the Carmat device.

If experience over the next year or so of the heart in patients confirms the promise of laboratory studies, patients and health professionals might have access to the new device for clinical use by 2015.

However it will of course take at least until 2020 to confirm whether, in general use, the hoped for 5 year lifespan of the device is confirmed for patients who have severe heart failure.

For the benefit of patients, health services and policy makers, there will need to be serious engagement with the biotech industry to ensure that economies of scale in clinical practice reduce dramatically the current huge cost per device - estimated at 140-180,000 €  ie around $240,000.

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