New FDA-approved heart pump for high-risk patients

Cardiologists at the University of Illinois Medical Center are using a new heart pump that can be inserted without the need for surgery and allows them to treat high-risk patients with a procedure to unblock their heart arteries.

The recently FDA-approved device was used to assist in three angioplasty procedures at the Medical Center last week.

Patients with the worst blockages are often the sickest, making it too dangerous to treat their coronary artery blockages with standard angioplasty or even with a bypass operation, says Dr. Adhir Shroff, assistant professor of cardiology at the UIC College of Medicine.

Shroff and his partners, Dr. Mladen Vidovich, assistant professor of cardiology, and Dr. John Kao, assistant professor of medicine, performed these procedures using the Abiomed Impella 2.5 ventricular assist device, which has been used only about 1,000 times in the country.

"Often these patients, who may have complicating conditions like cancer, renal failure, severe lung disease, or heart failure, are poor candidates for more invasive procedures like bypass surgery and are left with few options," said Shroff. "We only proceed with high-risk angioplasties after reviewing the patients with our heart surgeons."

Angioplasty is done by threading a thin, flexible tube, or catheter, into the coronary arteries through a small opening in a leg artery. It is much less invasive than open heart surgery, but has been largely restricted to managing low- to middle-risk patients.

The Impella heart pump makes it possible for cardiologists to offer the less invasive procedure to high-risk patients. "Our ability to continuously maintain blood flow will decrease complications during these high-risk cases where the patient had no other options to fix their heart arteries," Shroff said.

The Impella system uses a narrow catheter, which is threaded up from the groin, through the ascending aorta, and into the left ventricle. From this position, the Impella pumps blood from within the heart into the aorta, supplementing the weakened pumping of the patient's heart. The pump itself is smaller than a number-2 pencil eraser. Although it provides a large portion of the heart's work, it is silent and virtually imperceptible to the patient.

The Impella can be regulated during angioplasty to maintain blood flow, giving the physician the time needed to remove the blockage. If the patient needs further support, the Impella can be continued while the patient moves up to the ICU and until the heart is able to take on the task.

"We have created a seamless transition from the cath lab to the ICU," Shroff said. "We could not have done this without the collaboration of everyone who sees these patients as they move through the hospital, from the emergency room to the cath lab to the ICU. This exceptional effort on everyone's part, especially Nursing Services and the Cath Lab staff, allows UIC to offer the best possible care for patients with heart disease."