On December 29, 2022, the 2022 Critical Heart Disease Congress (CHDC) & International Society for Mechanical Circulatory Support (ISMCS) Parallel Forum was held online and offline as scheduled. Professor Nianguo Dong from the Department of Cardiovascular Surgery of Union Hospital, Tongji Medical College, Huazhong University of Science and Technology (hereinafter referred to as “Wuhan Union Hospital”) delivered an opening speech, as well as a speech entitled “Clinical Experience with the MoyoAssist® Extracorporeal Ventricular Assist Device”.
In his opening speech, Professor Nianguo Dong acknowledged the difficulties and challenges that still exist in the research, development, and clinical application of mechanical circulation support devices. He express his hope that this thematic discussion will bring together prominent experts and professors from both domestic and international communities to share valuable clinical experiences, participate in in-depth discussions, exchange technologies and work together towards the flourishing of mechanical circulation support.
Introduction to MoyoAssist® Extra-VAD
Later, Professor Nianguo Dong presented a speech entitled “Clinical Experience with the MoyoAssist® Extracorporeal Ventricular Assist Device” in which he pointed out that effective therapeutic methods for critical heart failure and end-stage heart failure mainly include heart transplantation and mechanical circulation assistance. Mechanical circulation assistance can be divided into short-term (< 3 months) and long-term (> 3 months), of which short-term mechanical circulation assistance devices mainly include extracorporeal ventricular assist devices (Extra-VAD), veno-arterial extracorporeal membrane oxygenation (VA-ECMO), intra-aortic balloon pump (IABP) and percutaneous ventricular assist devices (pVAD, Impella), while long-term mechanical circulation assist devices (implantable VAD) mainly include left ventricular assist devices (LVAD).
In clinical practice, if patients have unstable heart rates or even malignant arrhythmia due to heart failure, doctors will give them short-term mechanical circulation assistance devices to stabilize their condition, then choose from heart transplantation or long-term mechanical circulation assistance devices.
MoyoAssist® Extra-VAD, a short-term full maglev ventricular assist device jointly developed by Wuhan Union Hospital and magAssist with completely independent intellectual property rights, has obtained 19 invention patents, 10 utility model patents, six patent cooperation treaties and 28 overseas patents. Compared with VA-ECMO, IABP and pVAD, MoyoAssist® Extra-VAD has obvious advantages in support time, blood compatibility, nursing difficulty, heart unloading, etc.
Overview of Clinical Trials
By December 18, 2022, MoyoAssist® Extra-VAD had undergone clinical trials in 12 centers across the country with a total of 37 participants enrolled. The main assistance time was between three and 14 days. For different patients, it has achieved left ventricular assistance, right ventricular assistance or biventricular assistance, and helped different patients bridge to heart transplantation, recovery, intraoperative protection, weaning off support therapy, decision-making treatment, etc. More than half of the patients received minimally invasive surgery for MoyoAssist® Extra-VAD placement. The overall survival rate was 94.5%, meaning that the treatment effects were ideal.
Experience of Wuhan Union Hospital of China
How to Choose Extra-VAD or ECMO
ECMO is used when biventricular assistance is required in patients with respiratory failure. Left heart failure and mild respiratory abnormalities can be treated with Extra-VAD. In addition, right ventricular function needs to be comprehensively evaluated. Whether to use Extra-VAD for assistance depends on the patient’s specific symptoms, right heart size, right heart systolic function and tricuspid annular systolic displacement (TAPSE).
Clinical Progress of Wuhan Union Hospital
At present, 14 participants have been enrolled in Wuhan Union Hospital with an average age of 52.8 years. The average assistance duration of MoyoAssist® Extra-VAD is 9.1 days. More than half of the patients received a minimally invasive interventional approach pioneered by Wuhan Union Hospital to place the device. With the assistance of MoyoAssist® Extra-VAD, five patients were successfully bridged to heart transplantation, six were successfully weaned off support therapy and three were bridged to decision-making treatment. The overall adjuvant treatment effects of the 14 patients were good.
At the same time, Wuhan Union Hospital initiated a minimally invasive interventional approach to place the maglev Extra-VAD via the jugular vein and axillary artery, which can minimize trauma. This minimally invasive surgery achieved upper body intubation without affecting the patients’ lower limb movement. With the assistance of Extra-VAD, patients can eat independently and get out of bed to move around, which helps them recover and bridge to heart transplantation stably.