Fremont, Calif. -- A tiny device about the width of a drinking straw could be the key to
helping people that suffer a devastating heart attack. Washington Hospital’s
Heart program is the only program in the Bay Area using a new heart pump
-- Impella 2.5 Cardiac Assist Device -- that can help a weakened heart
function while damage is repaired. Two clinical trials of the cardiac
assist device are now underway at Washington Hospital, which is the only
facility in the Bay Area conducting these two studies.
“There are basically two reasons to use a heart pump,” says
Dr. Ash Jain, Medical Director of the Cardiac Catheter Lab and Peripheral
Vascular Services at Washington Hospital. “The first case would
be when the patient’s heart function is less than 30 percent and
the left ventricle needs help pumping blood out to the body. Heart pumps
also may be used for high-risk patients to keep the blood flow going during
balloon angioplasty procedures.”
The Impella 2.5 is a miniature heart pump that helps the left ventricle
chamber of the heart pump blood from the heart and through the aorta (the
main artery leading from the heart) into the body. When inserted into
the heart, the device speeds up the flow of blood and makes it easier
for the heart to do its job. While it is in place for hours or days, a
seriously damaged heart gets crucial time to recover. Or, it can give
doctors time to perform procedures such as opening blocked arteries, which
might otherwise kill the critically ill patient.
The device has received clearance from the U.S. Food and Drug Administration
(FDA) to provide immediate, minimally invasive circulatory support for
critical patients. Dr. Jain notes that surgeons currently use two types
of cardiac assist devices:
- A heart pump that is surgically inserted directly into the open chest.
- An intra-aortic balloon pump (IABP) that is inserted with a catheter through
an incision in the groin into the aorta to augment blood flow.
“Inserting the Impella 2.5 device doesn’t require an incision,”
adds Dr. Jain. “It is inserted percutaneously – meaning just
under the skin with a needle-puncture into the groin. Then it is guided
up through the femoral artery into the left ventricle. The Impella 2.5
sucks blood from the left ventricle and pumps it out at the rate of two
and a half liters per minute. The IABP also is inserted via catheter,
but it has limitations of supporting heart function. Since the IABP is
placed in the aorta, rather than the heart’s left ventricle itself,
it doesn’t pump as well.” The two studies being conducted
will compare the performance of Impella 2.5 devices with that of IABPs
in different circumstances:
- Recover II – Inserting the device when a patient comes in with a
heart attack and experiences extensive damage in cardiogenic shock.
- Protect II – Inserting the device prior to performing balloon angioplasty
in high-risk patients.