Mechanical Circulatory Conditions, Diagnostics & Treatments

Approximately 100,000 patients in the United States could benefit from advanced heart therapies, including heart transplant, but only about 2,300 donor hearts are available annually.

When medications can no longer help and all other surgical options are exhausted, a heart patient may be a candidate for a mechanical circulatory support device.

Conditions

Diagnostics
  • Automatic implantable cardioverter-defibrillator (AICD): Monitors rhythm and provides pacing or shock therapy as appropriate.
  • Cardiac biopsy: Samples a small piece of the heart to determine the cause of the heart muscle problem.
  • Cardiac MRI: A highly specialized type of MRI to study the heart muscle, valves and arteries. Cedars Sinai has the capability to perform this in many patients who have pacemakers.
  • Cardiomems implantable pulmonary artery pressure monitor: Guides medication treatment to reduce hospitalizations.
  • Cardiopulmonary exercise test (CPX or CPET): A bicycle test that analyzes the heart and lung function to determine the cause of shortness of breath.
  • Echocardiogram: Ultrasound of the heart to check the heart muscle and valve function, with specialized components at Cedars-Sinai incuding 3D, contrast and strain imaging.
  • Left heart catheterization: A catheter is passed into the heart to check for coronary artery blockages and measure heart function.
  • PET scan: A nuclear medicine study to search for heart muscle that would benefit from a stent or bypass surgery. Also a test used to look for sarcoidosis.
  • Right heart catheterization: A catheter is inserted into the right internal jugular vein and advanced into the right heart and pulmonary artery for hemodynamic assessment.
  • Technetium pyrophosphate scan: A nuclear study to identify a type of amyloidosis in the heart.
  • ZIO patch, Holter monitors and implanted loop recorders: Detect heart rhythm abnormalities.

Treatments

The expert team of surgeons and specialists in the Mechanical Circulatory Support Program at the Smidt Heart Institute offers the following services:

  • Providing cardiac and pulmonary support with extracorporeal membrane oxygenation
  • Durable and temporary devices
  • Assisting the left and/or right ventricle with ventricular assist devices
  • Total heart replacement

Treatment options for some advanced heart-failure patients include short-term and long-term mechanical circulatory support devices. These devices include:

  • Abbott-Thoratec Heartmate II
  • Abbott-Thoratec Heartmate III is the newest LVAD available. It is a small centrifugal pump that is implanted into the left ventricle. FDA approved for destination and bridge to transplant. We currently still support patients with Heartmate II LVAD.
  • Extracorporeal membrane oxygenation (ECMO) is a temporary device that provides circulatory support and oxygenation of blood for patients in cardiogenic shock.
  • Impella (CP, 5.0, RP) is a percutaneously placed catheter-based pump that provides temporary support of the left or right heart ventricle.
  • Medtronic HeartWare is a small, silent left ventricular assist device. It is FDA-approved as a bridge-to-transplant and currently in clinical trials for destination therapy in patients with end-stage heart failure.
  • SynCardia total artificial heart is an FDA-approved artificial heart to use as a bridge-to-cardiac transplant replacement. It also is under clinical trials for destination therapy.
  • Tandem heart is a small, external, short-term pump that supports either the left or right side of the heart. It is intended for short-term, bridge-to-cardiac recovery or a bridge to a longer-term device.