With the aid of an algorithm developed at the Medical University of Vienna in conjunction with the Ludwig Boltzmann Cluster for Cardiovascular Research and a recording device, it will in future be possible to analyse both the performance of the heart and of the pump down to the tiniest detail in patients with implanted heart pumps designed to keep them alive until they undergo a heart transplant. The aim of the new technology is to enable data to be used in clinical practice at any time and at the press of a button in order to make personalised therapy possible.
The insights gained are to be used to improve the treatment given to patients and also help develop the pump itself further. The interactions between the pump and the heart, along with their performance, are recorded 50 times a second. The most important questions, according to Heinrich Schima from the Centre for Medical Physics and Biomedical Technology at the MedUni Vienna, are: “Is the heart recovering? Is it also ejecting blood via the aortic valve itself? Is it beating irregularly?”
“The major goal is to develop an intelligent pump,” says Daniel Zimpfer, cardiac surgeon at the MedUni Vienna’s University Department of Surgery. “Currently, every pump that is implanted to support the heart operates with the same settings. The pumps are not yet able to adjust automatically to the physical effort and pumping performance required of each individual. We are working on making this possible.”
MedUni Vienna as a leading centre in cardiac support
At present, data is still transferred from the pump via a cable. But this is also – just like the charging of the cardiac pump's external batteries – soon to be possible without cables. Says Zimpfer: “In a decade at the latest, it may be possible to implant everything in the body. Batteries will then be charged through a type of WLAN.” Multi-centric, European studies into this are ongoing. “Thanks to its reputation, the MedUni Vienna is always involved in these types of project alongside the centres in Berlin, Leipzig, Hanover and Newcastle,” says Zimpfer.
The miniature circulating pump, which weighs just 150 grams, is generally used as a bridging solution until a possible heart transplant (“bridge to transplant”), especially in patients under the age of 70. In older patients, the pump, which is implanted directly into the left apex of the heart, is also used permanently. Inside the pump itself, the development of which the MedUni Vienna played a key role in around ten years ago, the system’s rotor floats freely in a magnetic field. As a result, there are no mechanical wear parts. Says Schima: “The pumps’ service life is therefore virtually unlimited.”
The role of cardiac pumps is to replace failing, diseased hearts or support them as they recover – until they are able to function independently without assistance. “The next generation of pumps will be even smaller and lighter, about the size of a thumb,” explains Schima.
In the USA, the trend is already heading towards the pump and away from transplantation. In the Clinical Department of Cardiac Surgery (headed by Günther Laufer) at the MedUni Vienna / Vienna General Hospital, the ratio is currently around 50:50.
European Transplant Congress in Vienna
From next Sunday (8.9) until Wednesday 11 September, the Austria Center Vienna will play host to the 16th Congress of the European Society for Organ Transplantation (ESOT). The event’s motto is “Pushing the limits”, and its keynote speaker is the three-times Formula 1 World Champion Niki Lauda, who has himself undergone numerous kidney transplants. Further information: http://congress.esot.org.
The fact that the most senior figures in transplant medicine and research are gathering in Vienna speaks volumes also for the esteemed position that the MedUni Vienna has earned itself in this field over the course of decades. The MedUni Vienna is one of the world’s leading centres for organ replacement – whether it be hearts, lungs or kidneys.