Complications arose during the operation. Matthias’ heart was stopped in order to perform the surgery, and a heart-lung machine was used to keep his circulation going. After the procedure, his heart is no longer capable of pumping enough blood on its own - the doctors aren’t able to wean Matthias from the heart-lung machine. It’s a life-threatening situation.
In this situation Matthias’ circulation cannot be stabilized, he has to be reanimated several times. Because of that Matthias is put into an artificial coma and connected to ECMO (Extracorporeal Membrane Oxygenation). A modified, miniaturized heart-lung machine that can be used to support heart and/or lung function for a few weeks so doctors have time to determine how to save his life. Unfortunately, as the doctors explain to his family, Matthias’ prognosis isn’t good. Since Matthias’ heart is unable to recover from the operation, he’ll need a heart transplant. It’s a shock for everyone involved. The average waiting period for a donor heart in Germany is several months.* And in the condition he’s in, Matthias may not have that kind of time left.
But Matthias’ wife, Doris, and his father, Josef, practically never leave his side, and remain in constant contact with the hospital for updates. “Giving up wasn’t an option,” says Doris, who fought for her husband’s life while trying to keep daily life going with their two sons (7 and 10). So it’s also thanks to her that, as a last resort, Matthias’ doctors ultimately chose to move him to University Hospital Regensburg.
The Regensburg facility has many years of experience with mechanical circulatory support systems. Though still on ECMO support, Matthias was brought out of his artificial coma to discuss further treatment options. Implantable continuous-flow systems only approved for left ventricular support were not an option for Matthias, because neither side of his heart was capable of pumping sufficient blood through his body.
Instead, Prof. Schmid, director of the Department of Cardiac, Thoracic, and Coronary Vascular Surgery at University Hospital Regensburg, elected to implant an EXCOR® Adult system. The paracorporeal, pulsatile system is especially designed and approved for biventricular circulatory support, making it the only option for keeping Matthias alive while he waits for a donor heart. Matthias and his family agree to the implantation. The operation is a success, and Matthias’ condition begins improving shortly thereafter. His recovery goes so well that, after just a few days, he can be mobilized and leave University Hospital Regensburg using a mobile EXCOR® system. Subsequent rehabilitation helps him recover his strength while he learns to use the system.
Finally, after four months, he is able to return home to his family and wait for a donor heart in the company of his loved ones. “Thanks to the two pulsatile pumps, my health has improved a great deal,” the 42-year-old electrical engineer says. “I feel good - much better than I would have expected when we originally decided to use the EXCOR®. My most recent laboratory results reflect that, too.”
Matthias, a managing director of a medium-sized company that manufactures assembly lines for the automotive industry, quickly grew accustomed to the system - so much, in fact, that he started working again in September 2019. For now, he works four hours a day, but if things keep going this well for him, he can see himself extending that to six- or eight-hour days.
“I don’t want to spend my days on the couch while I’m waiting for a donor heart,” he says. “It does me good to have work and family life to keep me occupied - they’re truly a gift.” The Harlander family has settled into a “new normal”: Doris and Matthias are back to work, and both are involved in the children’s after-school activities again. Matthias’ mobility plays a big role in that, representing both a challenge and a source of strength, and the family has a deep appreciation for each new day they face together.
We wish Matthias and his family the best, and we’re crossing our fingers that it won’t be long until a suitable donor heart becomes available to him.