March 23, 2009GAINESVILLE, Ga. – Cardiologists at Northeast Georgia Medical Center (NGMC) now have a new option to help treat people with severe coronary artery disease who are not eligible for conventional open heart surgery. An Impella Cardiac Assist Device (CAD) is now available in the Cardiac Catheterization Laboratory (also known as the cardiac cath lab). The U.S. Food and Drug Administration (FDA) approved the CAD in June 2008 after it was used in clinical trials to help support heart failure patients who have poor blood flow to their heart due to blocked arteries.
"Patients with poor heart function undergoing complex coronary angioplasty and stenting are at high risk for complications of heart attack, cardiac arrest and death. Although coronary bypass surgery is an option for many patients with complex anatomy and poor heart function, there are often situations where surgery is too high a risk," says Prad Tummala, MD, the medical director of NGMC’s Ronnie Green Heart Center. "We now have the option of utilizing the Impella CAD to relieve stress on the heart during these complex, life-saving procedures and support recovery for as many as five days."
The CAD is inserted into a catheter through the femoral artery next to the groin. A cardiologist guides the CAD over a 0.014" thick wire into the heart’s left ventricle, where the CAD sits. A motor inside the CAD starts helping the heart pump, increasing the flow of blood to as much as 2.5 liters per minute. The increased blood flow relieves stress on the heart during interventional procedures and supports recovery for as many as five days. Dr. Tummala has successfully used the CAD twice during recent weeks, the first such procedures performed at NGMC.
"The first patient was turned down for bypass surgery because he suffered from severe chronic obstructive pulmonary disease and we were worried about his recovery, specifically if we would be able to wean him off the ventilator," says Dr. Tummala. "The CAD allowed us to perform angioplasty and we were able to open two of the patient’s three blocked coronary arteries. He is currently recovering well at home."
The second case was even more dramatic.
"The second patient suffered an anterior MI (heart attack), which sent him into cardiogenic shock which contributed to kidney failure," says Dr. Tummala. "The patient was working with essentially one-sixth of his heart and likely had only days to live. He was also turned down for surgery as he would likely not have survived such an invasive operation. Again, the CAD increased the blood flow and supported the heart enough to allow us to perform very complex angioplasty on two arteries which had been 100-percent blocked for a long time."
The second patient recovered well. He is now being evaluated for either transplant surgery or surgical placement of a left ventricle assist device. Neither procedure was a possibility before the CAD paved the way for angioplasty, which stabilized the patient’s heart.
"The technology of this particular CAD is something that wasn’t available a year ago," says Dr. Tummala. "It’s reassuring to know that we have the latest technology and expertise to help patients with rather grave cardiovascular disease."
The use of CAD is covered by Medicare and many other major insurance plans. Call NGMC Public Relations at 770-219-3840 for more information.