New heart technology offers more options to critically ill

TUPELO – Some heart patients are so sick they can’t survive the surgery they need to give their hearts a second chance.
A partnership among cardiologists, cardiothoracic surgeons and North Mississippi Medical Center Heart Institute have opened up new possibilities with a tiny miniaturized heart pump that can be placed without opening someone’s chest. The pump can be inserted by using a catheter, threaded through an incision in the groin.
“This would be a tool to save a life until you get something more definitive,” said Tupelo cardiologist Dr. Barry Bertolet. “These are folks who didn’t have options six months ago,”
The tiny Impella pump takes over the work of the left ventricle, pushing oxygenated blood into the aorta.
For someone who comes into the hospital with a dying heart because of a severe heart attack or congestive heart failure, the Impella can potentially stabilize the person for bypass surgery or an artificial heart.
“All the other artificial hearts require time and preparation,” Bertolet said. “These people don’t have time.”
NMMC-Tupelo is one of three hospitals in Mississippi who currently offer the technology.
“We anticipate using it about twice a month,” Bertolet said.
First patient
Russell Glenn of Wheeler was the first NMMC patient to benefit from the new technology in April.
Glenn, who had been through four heart attacks, had two completely blocked coronary arteries and one significantly blocked artery. With so little blood supply reaching the muscles of the heart, his heart was extremely weak and open heart surgery was off the table for Glenn, who also has kidney and lung problems.
“After the heart attack in December (2009) they basically said there’s nothing we can do,” Glenn said.
Even using a catheter to open the blood vessels was out of the question without something to keep Glenn’s heart beating through the procedure, Bertolet said.
“I would have been working on the only blood vessels to his heart,” Bertolet said. “I would have been cutting off the supply to his heart.”
The Impella was able to support Glenn’s heart while Bertolet cleared two of the three blocked arteries. Although the device can stay in longer, Bertolet weaned Glenn off it in the cath lab after the stents were placed to keep the arteries open.
Glenn, who had been sidelined by heart failure, has continued to do well, Bertolet said. Tests during follow-up visits have shown improvement in his heart and his kidney function.
“Before he couldn’t breathe,” because of the heart failure, Bertolet said. “Now he’s well enough, he’s planted a garden.”

Michaela Gibson Morris/NEMS Daily Journal