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Baylor University Medical Center chosen as one of six US sites for trial of new total artificial heart

Dan M. Meyer, MDBaylor University Medical Center chosen as one of six US sites for trial of new total artificial heart Many patients with advanced heart failure can be managed by a left ventricular assist device (LVAD). But there are some patients who are not candidates for an LVAD because they have biventricular failure. Baylor Dallas has been chosen as one of six clinical trial sites for the world’s most advanced total artificial heart. “No major changes have occurred in the field of total artificial heart in decades, so we are very excited to be able to offer access to participation in a clinical trial for this innovative pump to our patients who qualify,” says Dan M. Meyer, MD, surgical chief of heart transplant and mechanical circulatory support at Baylor Dallas.

Next month, Baylor Dallas will become the first implanting site in the United States for a trial of an LVAD developed by a company in Japan. This device may be able to help support patients whose heart failure is a result of the heart being stiff, and thus, not dilated, rather than the usual enlarged and weakened heart. In addition, this LVAD has the potential to decrease a major complication, which is GI bleeding. The greatest challenge currently faced by the heart failure/heart transplant team is the new heart allocation system, implemented by the United Network for Organ Sharing (UNOS) in October 2018, which demands that organs go to the sickest patients no matter their location in the country. In the prior system, organs would go to the sickest patients in a particular UNOS region, and the regions were not always equitable.

“In the past, more than 50 percent of our patients would get an offer of an organ while outside of the hospital, when they were stable and therefore lower risk,” says Shelley A. Hall, MD, chief of transplant cardiology, mechanical circulatory support and advanced heart failure at Baylor Dallas. “Now the vast majority of patients will need to be in the hospital to get a chance at a new organ, increasing risk and costs. We don’t know what the long-term implications will be since we just started with the new system.”

Dr. Meyer adds, “The new system has definitely complicated the logistics of retrieving organs. We have to travel farther distances in an attempt to optimize outcomes for our patients. Because patients are sicker at the time of transplant, it taxes our team and our resources going in, as well as post-operative management of these critical patients.”

Both Dr. Hall and Dr. Meyer had leadership roles in working with UNOS to develop the new allocation system. Dr. Meyer was the initial chair of the heart committee for UNOS, and Dr. Hall is the current chair and continues to work with the organization to optimize the new system.

For critically ill patients with advanced heart or lung failure, extracorporeal membrane oxygenation or ECMO is available at Baylor Dallas and three other Baylor Scott & White medical centers. These hospitals have formed an ECMO collaborative to work collectively as a team to provide this much-needed care.

“This is the first time the hospitals in the North Texas and Central Texas regions are working together to get these critically ill patients the care they need close to home or transported to the appropriate facility for their condition,” Dr. Meyer says. “We go all over the southwest region to put these patients on ECMO on-site and then transport back to the right facility.”

“As innovations continue to be made in the field of heart failure, we are committed to aggressively pursuing clinical trials to bring the newest technologies to our patients,” Dr. Hall says. “Whether through research into new heart failure medications, advanced monitoring of heart failure patients, and for those who qualify, heart transplantation or implantation of an LVAD, our goal is to improve the clinical outcomes for patients with advanced heart failure.”


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