It resembles an apple that has a large corrugated tube instead of the stalk. Perforated surface, distant resemblance in shape to the natural human heart muscle, here is the most recent technological innovation. The last heart made in the laboratory is called Carmat Aeson and, like the less versatile predecessors, represents the so-called “bridge solution”, pending the actual transplant, and was implanted for the first time in Europe at the heart surgery center directed by Ciro Maiello at the Monaldi hospital in Naples.
The surgery was performed on a 56-year-old patient, whose current particularly delicate clinical conditions did not allow him to receive a new heart. And therefore, although Carmat’s temporary function now allows him to get by, there is always the hope (and the possibility) of a return to the parameters that make him a candidate for transplantation. The system, totally biocompatible, is all mechanical, equipped with 4 valves, also obviously biological, and works thanks to small battery-powered electric motors that pump blood into the aorta or pulmonary artery.
But the peculiarity of the device that Maiello considers fundamental is represented by the self-regulation mechanism: “These devices, and therefore also Carmat, are implanted in the thorax of subjects to be treated for biventricular decompensation. It means that both the right chamber of the heart and the left both are in decompensation. Carmat, through a series of sensors and software, adjusts itself. Just like a normal heart does: if the body needs a greater cardiac output, the device automatically increases the frequency “. But the 56-year-old decompensated Neapolitan, adds the director, presents another big problem because “he suffers from high pulmonary pressure. And this is the condition that currently does not allow him to undergo a transplant”.
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A technological progress, therefore, that opens the doors to the hope of a device, in the predicate of passing from a timed solution to a definitive one, thus avoiding even the transplantation in seriously decompensated patients. At the base of decompensation there is heart failure which occurs when the heart is no longer able to carry out its main function, that of “pump”, which is essential to ensure the flow of blood necessary to meet the needs of the body. Although mainly involving the left chamber of the heart, when it also affects the right, we speak of biventricular heart failure. And it’s a risky condition for vital organs such as the brain, liver and kidneys, which run dry of the oxygen needed to function properly.
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He also has his say on Carmat Marisa de feo, director of the department of Cardiac Surgery and Transplantation, in the hope that it will allow “to restore the lung function necessary to start the process for inclusion in the transplant list. The optimal management of the procedure was possible thanks to multidisciplinary work and cooperation among those who, for years, have been selecting patients with appropriate indication for total artificial heart implantation and Carmat specialists who have followed us both in the training phase in the laboratory of the Georges Pompidou hospital in Paris, and during the delicate operative and perioperative phase. And then, the new technology, much quieter, is easier to manage in the post-operative phase, ensuring a better quality of life for patients “.
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