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JERUSALEM — A 63-year-old man’s life was saved when, for the first time in Israel, doctors at the Hadassah Medical Organization performed a total artificial heart transplant. Only 114 such transplants have been performed anywhere in the world.
In Israel until now, even the most advanced life-extending devices implanted in patients were connected to a patient’s original heart. Patients requiring advanced cardiac devices received a partial support system — typically, a left ventricular assist device (LVAD), which supplements the existing heart. However, while LVADs help patients with left-side heart failure, they are ineffective when both chambers of the heart have collapsed.
During the complex, seven-hour operation, the patient’s heart was removed and replaced with an artificial heart made of titanium combined with biological animal tissue and advanced sensors. The artificial heart was developed by the French company CARMAT, represented in Israel by Tzamal Medical.
“This was a major milestone in Israel, something unprecedented,” said Offer Amir, MD, director of the Hadassah Medical Organization’s Heart Institute, who led the operation and the months of feasibility planning that preceded it.
Added Amit Korach, MD, head of the medical center’s Department of Cardiothoracic Surgery, who directed Israel’s first artificial heart transplant. “For the first time in Israel, we can offer a lifesaving solution for those whose entire heart has failed.
The complex procedure required a large medical team that included cardiologists, cardiac surgeons, anesthesiologists, intensive-care specialists, operating room nurses and a heart-lung machine technician. CARMAT’s cardiac surgeon and two technicians participated in the landmark operation.
The transplant necessitated the simultaneous use of two operating rooms. While the artificial heart was prepared for implantation in one operating suite during a highly precise process that included the addition of artificial valves, in another operating suite doctors removed the patient’s diseased heart and connected him to a heart-lung machine to keep him alive during the transition.
Once the implant site was ready, the artificial heart was connected to the patient’s main blood vessels, returning blood from the patient to the pump and sending it back out again. Gradually, the surgical team reduced support from the heart-lung machine while increasing support from the new heart until the patient was completely disconnected from external life support and the new heart was fully operational.
“It felt like I was standing in the future,” said Alexander Lipey-Diamant, MD, head of the Hadassah Medical Organization’s Adult Open Heart Surgery Unit and part of the transplant team, as were the medical center’s Rabea Asleh, MD, head of the Heart Failure Unit; cardiac surgeon Ayman Murar, MD; and senior anesthesiologist Ralitsa Stoynova, MD.Since the operation had never been performed in Israel before, it required months of preparation, including extensive coordination with the patient’s insurance provider and Israel’s Ministry of Health.
To prepare for the surgery, a Hadassah team traveled to France for special training, which was done alongside French cardiac surgeons and representatives of CARMAT, the artificial heart’s developer. After the Hadassah Medical Organization’s surgeons had mastered the transplant procedure, they returned to Israel and trained the rest of the medical team.
The decision to perform the transplant was made after a careful review of the patient’s condition. He had long suffered from heart failure and severe breathing difficulties, which greatly impaired his daily life, and faced a serious risk of death while waiting for a suitable donor heart. The expert team concluded that the transplant was his only option and tests confirmed he was a good candidate for the procedure.
The artificial heart will provide him with at least two full, high-quality years of life as he awaits a human heart transplant.
About the Hadassah Medical Organization:
For more than a century, the Hadassah Medical Organization, the Jerusalem-based nonprofit hospital system founded and owned by Hadassah, The Women’s Zionist Organization of America, has set the standard for excellence in medical treatment and research in Israel. The experience and ingenuity of Hadassah’s doctors and scientists have led to new tools and treatments in all areas of medicine, including therapeutics, diagnostics and medical devices. Visit hadassah.org/how-we-help/our-hospitals.