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Pump It Up

A tiny pump makes surgery possible for patients whose hearts are otherwise too weak

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A tiny pump on the Impella's catheter helps make sure enough blood is being pumped out of the heart to bring oxygen to the organs.
  • A tiny pump on the Impella's catheter helps make sure enough blood is being pumped out of the heart to bring oxygen to the organs.

What if you were faced with a grim decision: risk your life by having surgery or shorten it by not having an operation? This is a decision some heart patients and their families have had to make. New technology is making that choice easier — and saving lives.

  Bill Massey, 81, of Picayune, Miss., has experienced a lot of heart problems. Since 2009, he's had a heart attack, congestive heart failure, multiple blockages, stents inserted to hold open arteries and bypass surgery. "It scared me because I couldn't breathe," Massey says. "I just felt like I was going to die, really."

  He wears the LifeVest, an external defibrillator with paddles, in case his heart needs to be shocked back into rhythm. He has scars on his chest from the surgery, and wires on the inside hold his chest bone together. Last fall, when he began having shortness of breath and needed another heart procedure to save his life, doctors said his heart was too weak for surgery.

  Bad heart conditions are common in this area, says Dr. Ali Amkieh, an interventional cardiologist on the Northshore. "Louisiana (residents) in general have a high risk of cardiovascular disease, stroke, heart attack, high blood pressure, diabetes, smoking, all the risk factors for arthrosclerosis and heart disease," he says.

  Gail DeLeon, 67, a Covington heart patient, had a health problem similar to Massey's.

  "I had two major blockages, but I was not a candidate for surgery because my heart is very bad," she says. One artery was 100 percent blocked and the other was 60 percent blocked. Both DeLeon and Massey faced a difficult choice: die from the blockages or risk dying during the surgery that should open them.

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  Fortunately, Massey and DeLeon were in the right place at the right time. Technology offered them a new choice: using the world's smallest heart pump. Massey and DeLeon were the first two patients on the Northshore to use Abiomed's Impella 2.5 heart pump during surgery. Their doctors did the procedure at the Louisiana Heart Hospital in Lacombe.

  "It takes some of the load off the heart," Amkieh says. "It takes some of the load for pumping the blood out of the heart when the heart muscle is weak."

  During the surgical procedure, a thin catheter is put in a vessel in the groin. Doctors run it all the way up through that vessel and into the heart. A tiny pump on the catheter helps make sure enough blood is being pumped out of the heart to bring oxygen to the organs. Without this pump, the patient's weak heart muscle is not strong enough to do the job during surgery.

  The Impella was approved by the FDA in 2008 but is still not commonly used in hospitals. Insurance companies pay the cost of using the Impella pumping device during heart procedures. An Ochsner Medical Center spokesperson says doctors there have had the Impella technology since 2009 and have used the device in more than 60 patients with excellent clinical results.

  "I would have died a lot earlier (without) being able to have the surgery with the Impella and get the two arteries open," DeLeon says. "One of the arteries is the one they call 'the widow maker,' and it was pretty well blocked."

  Massey says the Impella changed his outlook on life. He went from having no hope for the future to looking forward to more retirement years to fish and garden.

  Last month, Massey and his wife celebrated their 61st wedding anniversary. One of their favorite pastimes is going to the casino, and Massey makes sure he puts in his half hour on the treadmill before he goes.

  "I'm feeling a lot better every day," Massey says. "I'm going to cardiac rehab twice a week and I'm getting stronger all the time. I'm not having any shortages of breath at all. My legs are weak, but I'm gaining strength."

Look for Meg Farris' Medical Watch reports weeknights on WWL-TV Channel 4 and anytime on wwltv.com.

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