“Our mission is to transform the health of the communities we serve and the Heart Hospital delivers on that promise in life-changing ways,” said Tom Miller, CEO of UofL Health. “We have dedicated the space, assembled the technology and most importantly we have the academic expertise and commitment to make a difference in Kentucky’s biggest health threat.”

According to the most recent Centers for Disease Control and Prevention data, heart disease remains Kentucky’s leading cause of death. The Heart Hospital is designed to change that statistic by saving lives and improving heart health. From the routine to the rare, and advancing research, the specially trained staff is dedicated to taking care of heart patients and their families.

“The UofL Health – Heart Hospital represents the future of heart care, in Kentucky and beyond,” said Lori Stewart Gonzalez, University of Louisville interim president. “This hospital combines comprehensive clinical care with academic expertise, training and breakthrough discoveries to advance heart care around the world.”

The Heart Hospital has more than 100 beds dedicated for heart patients. Rising 15-stories above downtown Louisville, with nearly 280,000 square feet, it provides leading-edge heart care on UofL Health’s academic medical campus. It includes six dedicated cardiac cath labs, two hybrid operating rooms, three electrophysiology labs and three cardiac operating rooms collectively equipped for TAVR, Watchmen Flex and heart transplant procedures. More than 300 heart care professionals make up the Heart Hospital team, with preventative and follow-up care extended to more than 30 locations across Kentucky and Indiana.

“Convenient access is essential to impactful care, that’s why the Heart Hospital extends care beyond downtown and into our community,” said , UofL Physicians – Cardiology Associates. “With early diagnosis, customized interventions and regular check-ups, our goal is to prevent the need for advanced care. But, if advance care is needed, the Heart Hospital means patients get the very best care, and still stay close to home.”

As part of UofL Health and through its alignment with both the University of Louisville School of Medicine and the Cardiovascular Innovation Institute, the Heart Hospital leverages the advantage of academic medicine. Medical heart firsts attributed to the UofL Health team include three world’s first transplants and cardiac stem cell procedures, along with a first-in-the nation procedure to relieve the symptoms of heart failure to improve cardiac function and quality of life. The Heart Hospital team is also credited with dozens of state firsts and has celebrated more than .

“When you come to the Heart Hospital you get access to the heart care standards of the future, today,” said , chair of the UofL Department of Cardiovascular and Thoracic Surgery. “We leverage our academic advantage to save and improve more lives. I’m proud to be part of a team committed to research and developing innovative heart care.”

All UofL Health – Heart Hospital locations are now available to assist patients, downtown and at more than 30 locations across the community.��

Jaimin Trivedi, assistant professor and director of clinical research and bioinformatics in the UofL Department of Cardiovascular and Thoracic Surgery, was lead author on an article�� last month that detailed the findings.

Trivedi and his colleagues in the department used data from the United Network for Organ Sharing (UNOS) database to analyze changes in the percentage of heart transplants for Black, white and patients of another race since 1987, when the database was established. They analyzed de-identified records for a total of 105,266 adults listed in the database for heart transplants from 1987 through 2020 by Black, white or another race, and the 67,824 patients from the list who received a heart transplant.

The proportion of Black patients on the UNOS heart transplant list increased from 7% in 1987 to 25% in 2019 and those who received transplants increased from 5% in 1987 to 26% in 2019.

According to , 14.2% of the U.S. population is Black or African American alone or in combination with another race.

“Black patients historically have had poorer access to heart transplants, evident in our study as fewer patients listed for transplant and fewer patients actually receiving the transplant,” Trivedi said. “But, as the general health care of heart transplant patients improved over the years and the knowledge of racial disparities came into light, all these things came together and eventually the proportion of Black patients listed increased over time.”

While the numbers indicate parity among patients of different races, Trivedi said an analysis of equity also must consider the increased risk for heart disease among Black patients.��

“The Black population is at higher risk of cardiac disease based on the CDC data, so that means there are more Black patients likely to have heart failure and they are more likely to require a heart transplant,” Trivedi said. “If we are just looking at two numbers in the proportion of patients transplanted right now, it’s improved, but we have to look at it from the perspective of how prevalent heart disease is in the Black community and then how many of them are getting a transplant. So more research has to be done before you can meaningfully say whether there is equity in access to heart transplants.”

The researchers also looked at three-year survival of heart transplant patients. Post-transplant outcomes improved for all patients over the study period due to better post-transplant care, more rapid treatment of transplant rejection and other factors, Trivedi said. Outcomes also improved for Black patients, which are reaching levels comparable to white and other patients in recent years.

“There has been a general improvement in transplant survival outcomes across the races. Black patients tended to do slightly more poorly than white patients, but when we look at more recent data over the past five or six years, we have seen that Black patient survival also has been improving and it is reaching par.”

Another factor affecting post-transplant survival is access to quality health insurance. With this in mind, the researchers compared data for individuals with private insurance with those who had Medicare or Medicaid, information that was included in the database since 1994.

They found that post-transplant survival for Medicare and Medicaid patients improved over time but remained marginally below that of privately insured patients. The improvement in survival of Black patients was seen through all insurance classes, particularly since 2012, which Trivedi said could be multifactorial but also partially due to reliable insurance coverage after the application of the Affordable Care Act.

The awards honor “those who have made an impact on health care in our community through their concern for patients, research, innovation, management skills and being on the frontlines fighting the Covid-19 pandemic,” according to the publication.��

The UofL honorees are:

• Front-Line Hero: Andrew Odom, emergency room charge nurse with UofL Hospital.
• Health Entrepreneur: Mahendra Sunkara, director of UofL’s and professor of chemical engineering, who worked to develop, commercialize and produce reusable N95-style masks during the height of the COVID-19 pandemic.��
• Health Equity Champions: Suzanne Kingery, director of the UofL Pediatric Endocrinology Fellowship Program; and Keith Miller, a trauma surgeon with UofL Health.
• Health Innovator: Mark Slaughter and Siddharth Pahwa (dual award), cardiovascular and thoracic surgeons with UofL Health; and Ted Smith, director of the Center for Healthy Air, Water and Soil in the , who collaborated with other researchers at UofL, including those in the����and��UofL Genomics and Bioinformatics Core facilities, to rollout innovative wastewater testing for pandemic tracking.
• Health Provider: Dawn Balcom, a nurse practitioner with the UofL School of Medicine and advanced practice specialist with the UofL International Travel Clinic.��

This year’s Health Care Heroes will be profiled in the Feb. 25��edition of Louisville Business First, and will be honored at an in-person event the day before at The Olmsted. You can register to attend .

The investigational device, currently intended as a bridge to heart transplant, is part of an Early Feasibility Study (EFS) sponsored by CARMAT, a French medical device company, in partnership with UofL, UofL Health – Jewish Hospital and the UofL Health – Trager Transplant Center.

Led by cardiothoracic surgeons Mark Slaughter and Siddharth Pahwa, both of UofL Health – UofL Physicians and the UofL School of Medicine, the team performed the implant of the device on Sept. 14, 2021 at UofL Health – Jewish Hospital. The same team completed the nation’s second implantation in a male patient last month, also at Jewish Hospital.

“For the other half of the world’s population, completion of this procedure by the Jewish Hospital team brings new hope for extended life,” said Slaughter, UofL Health surgical director of heart transplant and professor and chair of the Department of Cardiovascular and Thoracic Surgery in the UofL School of Medicine. “Size limitations can make it harder to implant artificial hearts in women, but the Aeson artificial heart is compact enough to fit inside the smaller chest cavities more frequently found in women, which gives hope to a wider variety of men and women waiting for a heart transplant and increases the chances for success.”

More than 3,500 individuals are awaiting a heart transplant in the U.S. and 900 of them are women. There are few treatment options for patients with biventricular heart disease, meaning both the left and right sides of the heart are not pumping blood adequately. The Aeson device is designed to solve the limitations of current left-ventricular assist devices, which pump blood in just one chamber, by pumping blood in both heart chambers.

Aeson also contains pressure sensors that estimate the patient’s blood pressure and automatically adapts cardiac output according to the sensor information. It is fully implanted as a heart replacement and powered by a portable external power supply.

During this procedure, the Aeson total artificial heart was implanted into a 57-year-old Kentucky woman with severe biventricular heart failure during an eight-hour surgery. The recipient, whose identity is being withheld upon request, was referred to the Advanced Heart Failure Therapies Program at Jewish Hospital earlier this year with end-stage heart failure and had undergone cardiac surgery years before. The patient is recovering well in the cardiovascular intensive care unit. Jewish Hospital is just one of four programs in the nation approved to perform this clinical trial procedure.

“The varying pumping ability of the Aeson device increases its viability among more patients,” said Pahwa, UofL Physicians cardiothoracic surgeon and assistant professor in the UofL Department of Cardiovascular and Thoracic Surgery. “While other devices are set at a fixed rate or create a continuous flow, CARMAT has developed the Aeson to automatically adjust the flow, creating an improved performance to meet the body’s changing blood flow needs.”

Currently, the Aeson artificial heart is tested as a bridge to transplant for patients with end-stage biventricular heart failure, allowing more time for the patient to receive a permanent heart organ transplant. The device already has been approved for such use in Europe, where approximately 20 devices have been implanted. It currently is being tested in the U.S. as part of a feasibility study approved by the Food and Drug Administration. The first Aeson artificial heart in North America was implanted in a male patient in July at Duke University Medical Center. The second implantation, also in a male patient, was performed at Jewish Hospital in August. This third North American implantation is the first to involve a female patient.

“Even as we have fought this deadly pandemic, our researchers and health care providers have also been on the front lines of improving care and quality of life for not only Kentuckians, but for people around the world,” said Kentucky Gov. Andy Beshear. “I am proud that UofL, Jewish Hospital and their doctors are leading the world in implanting this promising and innovative device that could offer hope and time to thousands of people, including our wives, mothers and other loved ones, in coming years.”

Stéphane Piat, chief executive officer of CARMAT, said, “This third implant in the U.S. was a landmark event not only because it allowed us to finalize the enrollment of the first cohort of patients of the EFS, but very importantly because it is the first time ever that our device has helped a woman suffering from heart failure. This achievement confirms that the size limitations for adults are minimal, which makes us very confident in Aeson’s potential to become a therapy of choice for a broad patient population.”

Preclinical research for CARMAT’s artificial heart began at UofL more than five years ago. Researchers at UofL’s Cardiovascular Innovation Institute tested Aeson’s autoregulation capability, which allows the device to adapt its flows according to the patient’s needs by detecting changes of pressure in the device. UofL researchers have conducted preclinical testing of artificial heart components and mechanical assist devices at CII for many years, testing some portion of nearly every mechanical assist device that is commercially available today.

Jewish Hospital and the University of Louisville share a storied history in advancing heart care. Highlights include:

• Aug. 24, 1984: Kentucky’s first heart transplant performed at Jewish Hospital by UofL physicians
• July 2, 2001: The world’s first AbioCor artificial heart was implanted at Jewish Hospital by UofL physicians, led by cardiothoracic surgeon Laman Gray
• Dec. 21, 2011: Kentucky’s first transcatheter aortic-valve replacement performed at Jewish Hospital by UofL physicians
• Jan. 18, 2015: Kentucky’s first HeartMate 3��left ventricular assist device implanted at Jewish Hospital by UofL physicians
• Feb. 21, 2018: UofL Health – Trager Transplant Center’s 500^th heart transplant performed at Jewish Hospital
• June 14, 2019: The first EvaHeart2 LVAD implanted as bridge to transplant at UofL Health – Trager Transplant Center
• April 22, 2021: UofL Health – Trager Transplant Center’s 1000^th TAVR performed at Jewish Hospital

“This world-first artificial heart implant into a female patient is another demonstration of UofL Health’s commitment to provide both the world-class care of today and develop the world-class standards of tomorrow,” said John Walsh, chief administrative officer of Jewish Hospital. “We celebrate this first as a milestone and recognize the hard work of Drs. Slaughter and Pahwa and the entire team. The true impact of their work will be measured in the dozens, hundreds and thousands of lives improved in the years to come.”

The patient who received the nation’s second Aeson implant, on Aug. 20, 2021, continues to improve at Jewish Hospital. An update is expected in the coming weeks.

The team, led by Mark Slaughter, MD, professor and chair of the Department of Cardiovascular and Thoracic Surgery in the UofL School of Medicine and lead cardiothoracic surgeon at UofL Health – Jewish Hospital, performed the implant of the investigational device on Aug. 20.

The artificial heart, Aeson, developed by French medical device company CARMAT, serves as a bridge to transplant for patients with end-stage biventricular heart failure – heart disease affecting both left and right sides of the heart – allowing more time for the patient to receive a permanent heart organ transplant. More than 3,400 individuals in the U.S. currently are awaiting a heart transplant and there are few other treatment options for patients with biventricular heart disease.

“We are excited to provide this new technology to patients in Kentucky and the surrounding region and be one of the first U.S. centers to implant this new total artificial heart” Slaughter said. “This device has the potential to save the lives of critically ill patients suffering from biventricular heart failure who currently have very limited treatment options.”

The new total artificial heart was implanted into a middle-aged man from Southern Indiana with severe biventricular heart failure during a seven-and-a-half-hour surgery. The recipient, whose identity is being withheld upon request, was referred to the Advanced Heart Failure Therapies Program at Jewish Hospital. The patient currently is doing well in the cardiac surgery ICU. The Advanced Heart Failure Therapies Program at Jewish Hospital is the only program in the area that is performing heart transplants, the latest in mechanical circulatory support and cell-based therapies for advanced heart failure.

“Innovative care is what put Jewish Hospital on the world map,” said John Walsh, chief administrative officer at Jewish Hospital. “UofL Health was formed, in part, with a promise to preserve and build on the transplant legacy for generations to come. This procedure is another lifesaving milestone.”��

The new device is designed to solve limitations of left-ventricular assist devices (LVAD), which pump blood in just one chamber, by pumping blood in both heart chambers. Aeson also contains biosensors that detect the patient’s blood pressure and position and automatically adapts cardiac output according to the sensor information. It is fully implanted as a heart replacement and powered by a portable external power supply.

“We are honored that our device is implanted at UofL Health – Jewish Hospital, which is recognized throughout the United States for its quality of care and cardiovascular research” said Stéphane Piat, Chief Executive Officer of CARMAT. “I would like to congratulate the teams at Jewish Hospital, the University of Louisville, as well as our technical and medical staff, on this exceptional milestone for both patients and our company.”

The device is medically approved in Europe, where approximately 20 have been implanted. The first Aeson artificial heart in North America was implanted in July at Duke University.

This is not the first time University of Louisville physicians and Jewish Hospital have made artificial heart history. Just over 20 years ago, on July 2, 2001, UofL cardiothoracic surgeon Laman Gray led the surgical team that implanted the first self-contained artificial heart in the United States at Jewish Hospital. The AbioCor artificial heart was implanted into Robert Tools, who lived five months on the device. The UofL surgical team also performed the first heart transplant in Kentucky at Jewish Hospital in 1984.

The iVAS is a minimally invasive alternative to ventricular assist devices for use in patients with severe heart failure, allowing more mobility and implant without open-heart surgery. The iVAS supports heart function and can be used temporarily while patients await a heart transplant or as a more permanent treatment. UofL is the only site in Kentucky participating in the iVAS trial.

The iVAS is a counterpulsation heart device, assisting the heart by pumping between beats while the heart is resting to increase the flow of blood and oxygen to the heart. Manufactured by the device consists of a balloon-type pump placed in the descending aorta. This pump is inflated and deflated to help move blood through the body. The intra-aortic pump is connected through the skin to an external drive unit. The new technology is an improvement over other heart assist devices such as the left ventricular assist device (LVAD) most significantly in that the iVAS is implanted with a minimally invasive procedure, not requiring open heart surgery.

“The iVAS is put in through a peripheral artery so it does not require opening the chest or placing the patient on a heart-lung machine,” said Slaughter, chair of the Department of Cardiovascular and Thoracic Surgery in the UofL School of Medicine and surgical director of heart transplant and mechanical assist devices for UofL and Jewish Hospital. “Through this clinical trial, we may find additional advantages such as the opportunity for patients to disconnect from the device intermittently. With the VAD, you are always tethered to the device. With the iVAS, you may be able to be untethered or turn it off for short periods,” Slaughter said.

Another benefit, Slaughter said, is patients are not required to be on long-term blood thinners, which can have serious side effects.

Robert Hughes, one of the patients who received the iVAS implanted by Slaughter in Louisville, had a heart attack in May and subsequently learned he had heart failure.

“I finished chemo for leukemia in January. I had gone from 200 pounds to 145 pounds and I was pretty weak,” Hughes said. “Then I had the heart attack on May 17. Afterward I was getting dizzy just standing. I felt like I would faint. It was very unnerving. I didn’t want to get out and do a nosedive at Pic Pac,” Hughes said.

Hughes’s diagnosis was advanced heart failure, but he did not qualify for either a heart transplant or open-heart surgery, so when he was presented with the iVAS as a long-term option, he was ready to participate in the trial. His iVAS was implanted on Aug. 13. Within a few weeks, he was able to go home.

“Since the surgery, I feel stronger and haven’t had dizzy spells. I am gaining my weight back,” Hughes said. “I am very pleased with the outcome. As far as I’m concerned, everything is a plus.”

Hughes said he has been able to get out for trips to the drug store or grocery store without fear of passing out. The external drive unit for iVAS weighs only 8 pounds, permitting patients to be discharged from the hospital to await transplant or continue their lives at home and free to go out in the community.

The goal of the is to determine whether iVAS is as effective as the LVAD. Including the two patients at Jewish Hospital, 70 patients have been implanted with the iVAS device in 12 centers across the United States.��

Learn more about clinical trials at UofL��.

“The value of such lectures comes from both the person in whose name the lecture is delivered and the content of the lecture itself,” said Malcolm DeCamp, MD, chief of thoracic surgery at Northwestern University. DeCamp delivered the fifth annual Laman A. Gray Jr., MD, Lecture in December, organized by UofL’s Department of Cardiovascular and Thoracic Surgery. The lecture is named to honor the long-time UofL cardiovascular surgeon who pioneered mechanical hearts and devices and now serves as executive and medical director of the Cardiovascular Innovation Institute.

“A lecture such as the Laman Gray Lecture provides an opportunity to invite a thought leader in a specific field to provide enrichment to a community of providers they may not have access to,” DeCamp said. “Invited lecturers provide a different perspective, new knowledge and a cross-pollination of thought and ideas. They broaden the horizons of practitioners, trainees and students and give them a glimpse of things coming down the road.”

A former Louisvillian who earned his medical degree at UofL in 1983, DeCamp said he was honored to give a lecture named for Gray.

“I grew up there (in Louisville) and know him. He represents the surgeon-scientist-engineer and is known for trying to think of engineering ways to reverse the problems caused by disease,” DeCamp said. “The Cardiovascular Innovation Institute is a bricks-and-mortar testament to the promise he created.

“We physicians all like doctoring and taking care of patients, but he adds the dimension of scientist to it.”

DeCamp’s lecture, “Interventions for Emphysema: Beyond Best Medical Care,” examined the current state of treatments for the disease. While lung volume reduction surgery has been shown to help patients live longer and have a better quality of life, the procedure isn’t as well known among practitioners and therefore isn’t recommended as much as perhaps it should be, he said.

“A 1,200-patient study found that significant patient improvement was durable five years after surgery,” DeCamp said. “Several non-surgical procedures currently show promise but they are as yet unproven. Why don’t we support procedures of excellent efficacy?”

It is a message that Mark Slaughter, MD, chair of the Department of Cardiovascular and Thoracic Surgery, believes is important to hear.��

“Staying abreast of the latest data and research is imperative in the field of cardiovascular surgery,” Slaughter said. “Events such as the Laman Gray Lecture and speakers who have the credentials of a Malcolm Decamp constitute one important way in which we can help educate our students, residents, faculty and referring physicians on the latest advances and can then translate that knowledge into best practices for our patients.”

The Laman A. Gray Lecture is supported by a generous gift from Hank and Donna Wagner.