MANHASSET, NY – A tiny implantable device in the heart is offering lifesaving help to patients at North Shore University Hospital who suffer cardiogenic shock following a heart attack. Such patients face a greater than 50 percent chance of dying because their heart can no longer pump enough blood to meet the body’s needs.
The device – the Impella RP – received FDA approval in January and was used for the first time in New York State on May 26 to save a 74-year-old woman’s life at Manhasset hospital. Had this been six months earlier, the patient’s outcome could have been much different, says Rajiv Jauhar, MD, chief of Cardiology at NSUH.
“Options that were available prior to this were really drugs or surgical interventions with machines that take over the work of the lungs and heart. These types of approaches took time and manpower when time was of the essence,” said Dr. Jauhar.
“The bottom line was, many patients were too sick for these interventions and by the time we mobilized the surgical team it could take 2 to 3 hours and so we just tried to ride it out with just medications, and it didn’t really work in a majority of our patients.”
The female patient had a right-sided infarction, meaning the right-side of her ventricle didn’t move very well and had a hard time pumping blood into the lungs to get oxygenated. She also had a blocked right coronary artery and dangerously low blood pressure.
“What the Impella device does is it has a motor on it, which takes blood from the large vein outside the heart and forces the blood into the lungs,” said Dr. Jauhar. “It essentially bypasses the right ventricle completely. “
Dr. Jauhar, along with Perwaiz Meraj, MD, an interventional cardiologist, and an advanced hemodynamic team implanted the device through a catheter requiring only a small hole in her leg.
The device can stay in a patient for up to 14 days, as the heart begins to stabilize on its own.
“She got markedly better within a matter of a few minutes,” said Dr. Jauhar, who also put a stent into her right coronary artery to open it.
“This is a dramatic innovation because it allows an interventional cardiologist to take care of very sick patients under dire time constraints to fix a blockage and also support the patient in the critical phase that they are in.”