The first successful application worldwide of a newly developed mobile heart-lung support system in the case of a patient suffering from an acute life-threatening blockage of the pulmonary vessels – a pulmonary embolism – has been carried out at the Mainz University Hospital. The highly automated system, known as "Lifebridge", was able to be connected to the inguinal vessels during resuscitation – that is to say directly following the embolism. “Lifebridge” immediately took over the functions of the lung and heart and in so doing immediately ensured the vital supply of oxygen to organs. Until now, this has only been possible with the aid of a heart-lung machine which, however, on account of its size, is only accessible within an operating theatre. Until such time as a patient can be connected to such a machine in an operating theatre a great deal of valuable time is lost.
"Just imagine", explains Professor Christian Friedrich Vahl, Director of the Department of Cardio-Thoracic and Vascular Surgery at the Mainz University Hospital, "a young man collapses and gasps for air right in front of you, loses consciousness and must be resuscitated immediately. If it is a case of a blocked pulmonary vessel, the patient suffocates in spite of all resuscitation measures, as the lung can no longer take up the necessary oxygen." Until now, there was only one chance in such a situation: an immediate operation with the fastest possible connection to a heart-lung machine.
In contrast, the implantation of the “Lifebridge” system - a mobile mini heart-lung machine – can actually be carried out during the course of resuscitation procedures and immediately establishes adequate functioning of the lung and circulatory system. "As in this case there was no alternative, we decided on this intervention", explains Professor Vahl. "The implantation was successful and with the support system running we were able to stabilize the patient to the extent that the necessary diagnosis confirming the pulmonary embolism could be carried out." Subsequently, the patient was successfully operated under the direction of senior physician Professor Uwe Mehlhorn. "Through the use of the 'Lifebridge' we gain valuable minutes – time in which the organs are again supplied with oxygen and during which we can thoroughly examine the patient, make an accurate diagnosis and administer adequate treatment", says surgeon Professor Mehlhorn in describing the benefits of the new therapy option.
The patient, who would probably have had no chance of survival under the given conditions without the availability of this treatment option in Mainz, has recovered well from the operation. Two weeks later he is clinically fine. He is suffering from memory loss in respect of the resuscitation phase.
"The insidious aspect", according to Professor Vahl, "is that any resuscitation efforts are useless if the lung cannot take in any more oxygen, as is the case with a fulminant pulmonary embolism. Although circulation is restored by reanimation, the organs and the brain continue to lack sufficient supply, as the blood contains insufficient oxygen. For patients with acute life-threatening pulmonary and cardiac disease, we now have in Mainz the possibility of bridging the critical period between life-threatening functional breakdown and a rescuing operation through the implantation of the 'Lifebridge' system. In addition, the world’s first successful use of
'Lifebridge' in the case of a pulmonary embolism represents an important success for the research and therapy of acute lung diseases in Mainz."
For many years now, one of the main research focuses at the Department of Cardio-Thoracic and Vascular Surgery in the core area of "minimal invasive surgery" is the further development of the heart-lung machine to an autonomous robot. This has been systematically researched in the Special Research Division 414. The system known as "Lifebridge" is such a miniaturized heart-lung support robot. Professor Uwe Mehlhorn, who has now used the system for the first time in the successful treatment of a pulmonary embolism, was also in charge of the experimental evaluation of the mobile mini heart-lung machine in trials on large animals and participated in its development from the very beginning.
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