Upgrade Opens Heart Therapy to Many More Patients
MADISON - A therapy is only as good as the number of patients it can safely help. That's why a new evolution in a device commonly used to help patients with failing hearts has interventional cardiologists excited about the opportunity to use it on a wider spectrum of patients.
Physicians at UW Hospital and Clinics' cardiac catheterization laboratory recently became the first in Wisconsin to begin using a second-generation version of a pump that takes over the job of pumping blood in very ill patients who have hearts that become weakened from coronary artery disease.
The primary difference between the original and new model of Abiomed Impella percutaneous left ventricular assist device (LVAD) is the size of the tubes inserted into the patient's arteries. The original TandemHeart LVADS have large tubes, which occasionally created an increased bleeding risk for certain patients.
"The main advantage of the new model is that it's a little bit smaller and easier to insert, so we think we can use it in a broader set of patients who have disease in their arteries, with fewer bleeding complications," says Dr. Matt Wolff, chief of cardiology for UW Hospital and Clinics. UW has been using the TandemHeart LVAD for four years. In that time, Wolff and his colleagues have inserted more than 30 devices.
According to Wolff, the new Impella LVAD could double or even triple the number of patients who receive the therapy each year.
It won't be viable for every patient, however.
"There are still some situations where we would need more blood flow and would be willing to accept the larger tubes to achieve that," says Wolff. "We're constantly weighing the risks and benefits of these devices in procedures we're doing, but we believe this will broaden the number of patients we can help with this overall strategy."
The percutaneous LVADs are different than the surgical version that have primarily been used as a bridge to heart transplant for patients whose hearts are failing but for whom a donor heart is not yet available. The pumping mechanism is a tool to assist doctors as they insert stents into blocked arteries.
In cases in which the patient is severely ill, the U.S. Food and Drug Administration has allowed a percutaneous LVAD to remain inside the patient for a longer period of time. More commonly, patients will rely on an LVAD for a period of days, weeks or months to help them recover from a serious heart event and prepare for more involved cardiac surgery.
Since introducing the new device last month, UW physicians in the catheterization lab have implanted four LVADs in heart patients. More than anything else, physicians are happy to have another tool in their treatment arsenal.
"It's tremendously exciting," says Wolff. "Other cardiologists don't have access to as wide a range of tools as we do. The ability to use cutting-edge technology in a multidisciplinary environment, we're really able to treat and offer hope to the sickest of patients."