COULD THE FULLY IMPLANTABLE LIONHEARTTM BE A FUTURE SOLUTION CONSIDERING THE LIMITED NUMBER OF DONORS FOR CARDIAC TRANSPLANT?

Cardiac failure constitutes one of the main health problems in western countries. Despite the recent outstanding progress the pharmaceutical treatment of this condition is not suitable to overcome a great percentage of failures and an insufficient quality of life for many patients. The heart transplantation today is considered the most suitable therapeutic option. However, the limited number of donors compared to the great number of patients on the waiting list constitute a major limitation of this solution. The initial experience on the development of cardiac assist devices conceived as a “bridge to the transplantation†based on mechanical circulatory support has provided encouraging results to use such devices (ventricular assist devices) for a long period which could be considered as an acceptable therapeutic solution. The recent technological developments have made available the necessary miniaturization of the various mechanical components of the system for ventricular assistance and the proper solution for energy supply and control. On the light of the positive results obtained the ventricular assist devices can be considered today a permanent solution for a significant number of patients. This chapter illustrates the first Italian experience on the clinical application of the LionHeart, a totally implantable system for ventricular assistance. A concise description of the system and the surgical technique for implantation are provided and the preliminary results on the short term are discussed. Even considering the limited period of observation, this therapeutic option appears to be safe and suitable for a selected population of patients which cannot be considered proper candidates for heart transplantation.