Saygın Klinik

Heart Failure

What is Heart Failure?

The first approach to be done in heart failure is to name it. Heart failure means that the heart cannot pump blood at the strength it normally needs to contract. Normally, our heart works like a water pump inside the chest, and every time it contracts, a clean glass of water from the lungs pumps 70% of the blood forward and 30% stays in the heart. The amount of blood pumped by the heart every time it contracts, is called “ejection fraction”, that is, the rate of blood that it throws forward each time the heart contracts. This ratio is usually 65-70. In other words, in a normally contracting heart, when the heart beats;  70 ml of 100 ml of total blood pumped forward when it contracts, we say that this heart contracts with 70% performance, that is, it contracts well. As you know, a vehicle has engine horsepower, for example 90 horsepower. As the engine ages, the engine performance, engine power regresses and decreases.  Similarly due to these diseases in the heart, vascular occlusions, heart attacks, infections of the heart we call myocardium, after a certain period, it becomes unable to contract sufficiently at advanced ages. . In other words, while it will normally pump 70% of blood forward each time it contracts, this decreases down  to  60%, 40%, 30%. When 100 ml of blood comes from the lungs, some hearts pump only 20% of this clean blood, so 80% of the incoming blood stays in the heart. When the incoming blood cannot be pumped  forward and contraction power of the heart and pumping power falls from 65%-70% to 40% or below, heart failure starts in patients.

Heart Failure Treatment

In heart failure, if the contraction power of the heart  drops down to 20% horsepower or below, ( instead of normal value of 65%) we install a heart support device in these patients, and this dramatically improves the picture of heart failure. It significantly increases our patient’s daily performance, walking distance and daily exercise capacity. We apply heart support devices while the heart is beating by making a small incision in the chest. Of course patient stays under general anaesthesia and feels no pain.

While the heart is working, we place a finger-shaped motor inside the chest. On both sides of this motor,  there are vascular hoses made of fabric, and surgeon connects one end of these vascular hoses to  the left ventricle of the heart end to end  – part of the heart that receives clean blood -and i hose like tubular vessel graft is  connected to the  hole on left ventricle end to end, just like connecting a plumbing pipe.

We connect the tube at the other end of this finger-shaped magnetic motor to the main vessel that distribute the clean blood to all the organs of the body, which we call the “aorta”.  Thus, after putting this magnetic motor in place, of course, we need to carry energy to it, and we connect this energy to 2-3 battery modules the size of a mobile phone with the cables we take out from the tunnel we created on the anterior wall of the abdomen, where our patients can increase the speed of the pump while walking, and slow it down while lying down and resting. The heart has to pump clean blood coming from the lungs in a normal situation. Since the heart cannot contract, this pump surgeon implanted; draws this clean blood, which accumulates in the heart, like a vacuum, from the other side, it pumpes  the volume of blood to the main distribution pipe of the body, which we call the aorta, with a high pressure, and continuously presses it and thus reduces the load on the heart, we direct the blood from the whole lung to the body, that is, the heart rests for a while. Especially at the Texas Heart Institute, where Doctor Mustafa Saygın was trained, thousands of patients had the opportunity to wear this device while waiting for a heart transplant. Even in our patients whose heart did not contract at all during the application of this device, and who had lost nearly all pump function, when followed up with this heart support device for 3-6 months, it was seen that the heart got stronger again.

EECP Treatment in Heart Failure

EECP is to  treat heart failure by applying external pressure to the body, we call it external counterpulsation. While the heart is expanding, the  EECP  machine produce pressure  in  synchrony  with the rhythm of the heart,  thus increaseing the blood flow in the heart vessels by squeezing the body. With a strong external compression within 1 second, we increase the vascularity in the heart and the clean blood perfusion  of the heart with the whole body air pressure. This machine is applied 1 hour every day for  35-40 days.  Technology and EECP  is  FDA approved  treatment modality.