St. Luke’s Episcopal Hospital, Home of Texas Heart® Institute, First in Texas to Use New FDA-Approved Catheter-Based Heart Pump for High-Risk Patients
St. Luke’s Episcopal Hospital (SLEH), home of Texas Heart® Institute (THI), is the first in Texas and among the first in the nation to use a new heart pump that allows the heart to rest while cardiologists perform minimally invasive heart repairs on high-risk patients.
Known as the Impella CP™ (Cardiac Power), the pump received clearance in September 2012 from the U.S. Food and Drug Administration (FDA). The device is inserted via a soft-flexible tube, or catheter, through a small incision in the groin and threaded through the femoral artery and eventually into the left ventricle of the heart. Once in position, the Impella CP takes over the pumping function of the heart, pumping 3.5 liters of blood per minute through the body, which is approximately 80 percent of what a healthy heart can pump.
THI-affiliated interventional cardiologist Andrew Civitello, MD, said the Impella CP is an improvement on two previous versions of the pump – the Impella 2.5 and Impella 5.0. The Impella 2.5 only pumps 2.5 liters of blood per minute, half the amount of a healthy heart, and the larger Impella 5.0 pumps 5 liters per minute, equivalent to what the heart pumps, but requires insertion through a much larger incision because of the device’s size, therefore requiring surgery.
“The Impella CP is a happy medium that can support the heart during minimally invasive procedures performed in the Cardiac Catheterization Laboratory, eliminating the need for surgery,” said Dr. Civitello, who has been involved with this family of heart pumps since the FDA approved the first for use in the United States. He was on a panel of cardiologists invited to give input to the developer, Abiomed, Inc., and is among those who recommended development of a pump the size of the Impella CP.
This latest version of the pump makes procedures possible that could be very risky for patients with weakened hearts.
“As a tertiary heart center, we get patients who are referred from other centers and who have run out of options,” Dr. Civitello said. “This allows us to perform treatments that could not be performed at most hospitals.”
The new pump benefits three groups of patients, he said. The first are those who need coronary revascularization, a procedure that restores the blood supply to the heart, and whose hearts are too weak for either open-heart surgery or standard angioplasty.
This was the case with the first patient treated at SLEH using the Impella CP. On November 9, 2012, interventional cardiologist Leo Simpson, MD, used the pump to support the heart of 46-year-old Lloyd Willis during a procedure in the Catheterization Lab to unblock a heart artery. Willis, a resident of Pitkin, La., suffered from unstable angina due to severe coronary artery disease.
A husband and father of three sons, Willis said he had been treated for heart disease since 2005, beginning in Louisiana. Treatment included numerous heart catheterizations, stents and heart bypass surgery.
“Every time I have a heart catheterization, I almost die from it,” Willis said.
Willis, who most recently worked in construction, was told a couple of years ago that he no longer could work in that field because of his heart condition. He also noticed he lacked enough air when he was singing at his church, prior to his recent procedure at SLEH.
Now, “I feel great,” Willis said, noting it’s not only easier to sing, but he also has more energy.
“It definitely saved his life,” said Monica Willis, his wife.
A second group of patients who can benefit from the Impella CP are those with ventricular tachycardia, a life-threatening fast heart rhythm. Dr. Simpson, who also is an electrophysiologist – a cardiologist specializing in the treatment of abnormal heart rhythms – has treated two such patients at SLEH using the new pump. Jie Cheng, MD, and Nilesh Mathuria, MD, who are among the few electrophysiologists who specialize in treating these types of high-risk patients, referred them both.
The third group of patients who stand to benefit from the Impella CP are those in cardiogenic shock, a condition that results when the heart fails to pump effectively. It can be due to damage to the heart muscle, frequently from an acute heart attack, and causes dangerously low blood pressure. In this instance, the Impella CP can be used to stabilize patients until they can be surgically implanted with a left ventricular assist device (LVAD), a device that helps the heart pump blood.
“Despite its small size, the Impella CP functions like a temporary LVAD that cardiologists can use in the Catheterization Lab and insert quickly,” Dr. Civitello said.
