Herzunterstützungssysteme
Für Patienten mit terminalem Herzversagen, die bereits bei geringer Anstrengung oder in Ruhe Luftnot verspüren und bei denen herkömmliche Therapiemöglichkeiten ausgeschöpft sind, gibt es die Möglichkeit das Herz mechanisch durch sogenannte Herzunterstützungssysteme (VAD) oder sogar komplett durch ein Kunstherz zu ersetzen (TAH). Für jüngere Patienten (ca. < 65 Jahre) ist eine solche Kunstherztherapie gedacht, um die Zeit bis zur einer möglichen Herztransplantation zu überbrücken (bridge-to-transplant). Für ältere Patienten oder solche, bei denen eine Herztransplantation aus anderen Gründen nicht in Frage kommt, sind diese Unterstützungssysteme auch als dauerhafte Lösung gedacht (destination therapy).
Besondere Expertise
Prof. Albert besitzt eine langjährige Erfahrung in der Therapie der terminalen Herzinsuffizienz mittels maschineller Herzunterstützungssysteme. Er hat das Kunstherzprogramm in Düsseldorf 2010 mit aufgebaut und neue Techniken zur Rechts- und Linksherzunterstützung entwickelt [1,2,3]. Zudem hat sein Team das erste Mal weltweit ein Herzunterstützungssystem vom Typ Heartmate 3 minimal-invasiv und ohne Verwendung der Herz-Lungen-Maschine implantiert [5]. Zudem besitzt er, als einer der wenigen Chirurgen, Erfahrung in der Implantation von totalen Kunstherzen (Syncardia TAH).
Videos
Abbott’s HeartMate 3™ LVAD
Video mit freundlicher Genehmigung von Abbott.
HeartMate 3 Offers New Hope
Video mit freundlicher Genehmigung von Abbott.
Ausgewählte Literatur
Nikolaos Kalampokas, Nihat Firat Sipahi, Hug Aubin, Payam Akhyari, Georgi Petrov, Alexander Albert, Ralf Westenfeld, Artur Lichtenberg, Diyar Saeed. Postcardiotomy veno-arterial-extracorporeal membrane oxygenation; does the cannulation technique influence the outcome?" (acceptred) Frontiers in Cardiovascular Medicine 2021
Jawad K, Sipahi F, Koziarz A, Huhn S, Kalampokas N, Albert A, Borger MA, Lichtenberg A, Saeed D. Less-invasive ventricular assist device implantation: A multicenter study. J Thorac Cardiovasc Surg. 2020 Dec 23:S0022-5223(20)33396-1. doi: 10.1016/j.jtcvs.2020.12.043.
Weber A, L Büttner A, Rellecke P, Petrov G, Albert A, Sixt SU, Lichtenberg A, Akhyari P. Osteopontin as novel biomarker for reversibility of pressure overload induced left ventricular hypertrophy. Biomark Med. 2020 May;14(7):513-523. doi: 10.2217/bmm-2019-0410. Epub 2020 May 28. PMID: 32462909.
D.Saeed, K.Jawad, F.Sipahi, S.Huhn, N.Kalampokas3A.Albert, M.Borger, A.Lichtenberg. Reduced Rethoracotomy Rate for Bleeding and Postoperative Hospital Stay with Less Invasive Ventricular Assist Device Implantation, Multicenter Experience. J Heart Lung Transplant 2020;39: S149-S150
N. Kalampokas, S. Erbel-Kurdtsize, M. Arkikan, P. Rellecke, U. Boeken, A. Albert, A. Lichtenberg, H. Aubin, P. Akhyari. Effects of Preoperative Levosimendan on Perioperative Outcome after LVAD Implantation. Thoracic Cardiovasc Surg 6 2020; 68(S 01): S1-S72
M Brockmeyer, Y Lin, A Karathanos, C Parco, T Krieger, Y Heinen, A Albert, M Kelm, V Schulze, G Wolff . P2792 Preoperative levosimendan improves survival in patients with low cardiac output syndrome undergoing cardiac surgery: a meta-analysis of randomized controlled trials. European Heart Journal, Volume 40, Issue Supplement_1, October 2019, ehz748.1107
Saeed D, Maxhera B, Westenfeld R, Lichtenberg A. Albert A (2015). An Alternative Approach for Perioperative Extracorporeal Life Support Implantation. Artif Organs. 2015:719-23.
Saeed D, Maxhera B, Kamiya H, Lichtenberg A. Albert A (2015). Alternative right ventricular assist device implantation technique for patients with perioperative right ventricular failure. J Thorac Cardiovasc Surg. 149:927-32.
Saeed D, Maxhera B, Lichtenberg A. Albert A (2014). Intraventricular pledgetted sutures to prevent suction events in patients with the heartware left ventricular assist device. Ann Thorac Surg. 98:746-7.
Wieloch R, Sipahi NF, Boeken U, Albert A , Akhyari P, Westenfeld R, Lichtenberg A, Saeed D. Ventricular assist device in a patient with congenitally corrected transposition of the great arteries and situs inversus totalis. Int J Artif Organs. 2019 Jun;42(6):321-322. doi: 10.1177/0391398818823768. Epub 2019 Jan 10
Maxhera B, Sipahi NF, Albert A , Boeken U, Lichtenberg A, Saeed D. Preoperative and intraoperative extracorporeal membrane oxygenation adoption for long-term left ventricular assist device implantation. Ann Cardiothorac Surg. 2019 Jan;8(1):167-169. doi: 10.21037/acs.2018.10.02. No abstract available [Epub ahead of print
Mehdiani A. Albert A , Lichtenberg A, Saeed D. Applying a clampless haemostatic device for left ventricular assist device outflow graft anastomosis. Eur J Cardiothorac Surg. 2019 Nov 1;56(5):1009-1010. doi: 10.1093/ejcts/ezz060
H. Aubin, S. Eschlböck, P. Rellecke, G. Petrov, H. Dalyanoglu, D. Saeed, U. Boeken, P. Akhyari, A. Albert, A. Lichtenberg. Organ Recovery and Functional Status in Survivors of ECLS Therapy for Cardiogenic Shock. Thorac cardiovasc Surg 2019; 67(S 01): S1-S100. DOI: 10.1055/s-0039-1678884
R. Wieloch, A. Albert, A. Mehdiani, U. Boeken, H. Aubin, R. Westenfeld, P. Akhyari, A. Lichtenberg, D. Saeed. Experience with Long-Term Contiunous Flow Ventricular Assist Deviceas Bridge to Recovery Concept. The Journal of Heart and Lung Transplantation. Volume 38, Issue 4, Supplement, April 2019, Pages S369-S370
F. Sipahi, A. Mehdiani, A. Albert, H. Aubin, U. Boeken, P. Akhyar, R. Westenfeld, A. Lichtenberg, D. Saeed. Single Center Experience with 52 Less Invasive Left Ventricular Assist Device Implantations. The Journal of Heart and Lung Transplantation, Volume 38, Issue 4, S369
Ise H, Kitahara H, Aubin H, Saeed D, Westenfeld R, Akhyari P, Boeken U, Walz R, Albert A , Lichtenberg A, Kamiya H. Additional unloading of the left ventricle using the Impella LP 2.5 during extracorporeal life support in cases of pulmonary congestion. J Surg Case Rep. 2018 Nov 13;2018(11):rjy302. doi: 10.1093/jscr/rjy302. eCollection 2018 Nov
Wieloch R, Sipahi NF, Boeken U, Albert A , Akhyari P, Westenfeld R, Lichtenberg A, Saeed D. Ventricular assist device in a patient with congenitally corrected transposition of the great arteries and situs inversus totalis. Int J Artif Organs. 2019 Jan 10:391398818823768. doi: 10.1177/0391398818823768.
Abdeen MS, Albert A , Maxhera B, Hoffmann T, Petrov G, Sixt S, Roussel E, Westenfeld R, Lichtenberg A, Saeed D (2016). Implanting permanent left ventricular assist devices in patients on veno-arterial extracorporeal membrane oxygenation support: do we really need a cardiopulmonary bypass machine? Eur J Cardiothorac Surg. 50:542-7.
Maxhera B, Albert A , Westenfeld R, Boeken U, Lichtenberg A, Saeed D (2015). Minimally Invasive Right Ventricular Assist Device Implantation in a Patient with HeartWare left ventricular Assist Device. ASAIO J. 61:e42-3
Maxhera B, Albert A , Ansari E, Godehardt E, Lichtenberg A, Saeed D (2014). Survival predictors in ventricular assist device patients with prior extracorporeal life support: selecting appropriate candidates. Artif Organs. 38:727-32.
Saeed D, Albert A , Westenfeld R, Maxhera B, Gramsch-Zabel H, O'Connor S, Lichtenberg A, Winter J (2013). Left ventricular assist device in a patient with a concomitant subcutaneous implantable cardioverter defibrillator. Circ Arrhythm Electrophysiol. 6:e32-3.
Saeed D, Albert A , Kamiya H, Maxhera B, Westenfeld R, Lichtenberg A (2012). Five days of no anticoagulation or antiplatelet therapy and NovoSeven administration in a HeartWare HVAD patient. Artif Organs. 36:751-3.
Saeed D, Sixt S, Albert A , Lichtenberg A (2016). Minimally invasive off-pump implantation of HeartMate 3 left ventricular assist device. J Thorac Cardiovasc Surg. 152:1446-1447.
Saeed D, Maxhera B, Albert A , Westenfeld R, Hoffmann T, Lichtenberg A (2016). Conservative approaches for HeartWare ventricular assist device pump thrombosis may improve the outcome compared with immediate surgical approaches.Interact Cardiovasc Thorac Surg. 23:90-5.
Merle P, Maxhera B, Albert A , Ortmann P, Günter M, Lichtenberg A, Saeed D (2015). Sexual Concerns of Patients With Implantable Left Ventricular Assist Devices. Artif Organs.:664-9.
Saeed, D, Maxhera B, Sadat N, Petrov G, Albert A , Lichtenberg A (2017). Gastro-Intestinal Bleeding in Patients with HeartWare Ventricular Assist Device: does the Activation of the lavare cycle make a Difference?" ASAIO J (accepted May 11, 2017)
Saeed D, Westenfeld R, Maxhera B, Keymel S, Sherif A, Sadat N, Petrov G, Albert A , Lichtenberg A (2016). Prevalence of De Novo Aortic Valve Insufficiency in Patients After HeartWare VAD Implantation with an Intermittent Low-Speed Algorithm. ASAIO J. 62:565-70.
Saeed D, Assmann A, Abdeen M, Albert A , Maxhera B, Sadat N, Sixt S, Lichtenberg A (2016). Implanting permanent left ventricular assist devices in patients on veno-arterial extracorporeal membrane oxygenation support. Multimed Man Cardiothorac Surg. mmcts.2016.003.
Sellmann T, Saeed D, Danzeisen O, Albert A , Blehm A, Kram R, Kindgen-Milles D, Hoehn T, Winterhalter M (2012). Extracorporeal membrane oxygenation implantation via median sternotomy for fulminant pulmonary edema after cold water submersion with cardiac arrest. J Cardiothorac Vasc Anesth. 26:887-9.
Saeed D, Albert A , Kamiya H, Maxhera B, Westenfeld R, Lichtenberg A. Five Days of No Anticoagulation or Antiplatelet Therapy and NovoSeven Administration in a HeartWare HVAD Patient. Artif Organs. 2012 Au
g;36(8):751-3. doi: 10.1111/j.1525-1594.2012.01473.x. Epub 2012 May 20
Saeed D, Stosik H, Islamovic M, Albert A , Kamiya H, Maxhera B, Lichtenberg A (2014). Femoro-femoral versus atrio-aortic extracorporeal membrane oxygenation: selecting the ideal cannulation technique. Artif Organs. 38