Recent advances in heart pumps are making both open heart surgery and interventional cardiology procedures safer for patients. At the AdventHealth Tampa Pepin Heart Institute, cardiac surgeons and interventional cardiologists are using a group of pumps known as Impella to keep patients’ blood circulating at normal levels during complex procedures. This is known as hemodynamic support. Hemo comes from the Greek word for “blood,” and dynamic comes from the Greek dynamis that means “force” or “power.” These Impella pumps help doctors in situations when the left ventricle – responsible for pumping blood to the rest of the body – is simply too weak to do its job.
“The Impella also unloads the heart and supports blood pressure with improved cardiac output, supporting end organ perfusion,” says Rozales Swanson, MD, a cardiovascular and thoracic surgeon, codirector of the Pepin Heart Institute and codirector of the institute’s Advanced Heart Failure and Mechanical Support Program. In other words, the Impella makes sure the body’s vital organs receive the blood they need.
Impella: A Heart Pump Used for High-Risk PCI at AdventHealth Tampa
The main purpose of the Impella is to assist interventional cardiologists with percutaneous intervention (PCI) for high-risk patients. PCI is a minimally invasive way to remove blockages in the arteries in the heart through angioplasty and stenting. The Impella pump is very small – the width of only a few millimeters. It can be inserted through a catheter (thin, flexible tube) into the skin and threaded through the arteries into the heart’s left ventricle. Once in place within the heart, it is activated to assist the heart in pumping blood.
By giving patients hemodynamic support – keeping their blood pumping – during their PCI procedure, doctors can improve patient outcomes. Using the Impella has been shown to allow faster recovery of systolic function and decrease morbidity. This means certain patients have better outcomes when it is used.
Impella Associated with Improved Survival for Patients with Cardiogenic Shock after a Heart Attack
Some patients who have particularly severe heart attacks experience a condition known as cardiogenic shock. This means that the heart cannot pump enough blood to support the body’s most important organs. While PCI is used to unblock these patients’ coronary arteries, the Impella has an important role to play in supporting them through this process.
Studies show that when doctors insert an Impella prior to PCI, it leads to better outcomes. This approach makes it more likely that the patient’s heart will function more normally after the PCI procedure, and thus increases chances for survival.
Impella Treatment for Postcardiotomy Failure
The Impella can be a lifesaver for open heart surgery too. For many of these operations, patients are placed on a heart-lung machine so their heart can stand still for surgery. The heart-lung machine ensures that their bodies continue to receive oxygenated blood.
In rare cases, patients have difficulty coming off the heart-lung machine when their operation is over. For example, they may develop a condition called postcardiotomy shock. This is when the heart doesn’t work as usual. Patients’ blood pressure begins to drop and their hearts can’t sustain normal function. This condition is life-threating and associated with very high mortality rates of up to 4 in 5 patients.
“With Impella we now have an option to offer patients which results in less mortality and morbidity,” says Dr Swanson. While extracorporeal membrane oxygenation (ECMO) was previously the primary way to treat patients with postcardiotomy shock, ECMO – as well as the intraaortic balloon pump – led to many complications and reduced quality of life for some patients.
Now, heart surgeons can use the Impella to provide the ideal hemodynamic support patients need after leaving the operating room. While it is in place, the Impella gives patients’ heart function and overall condition a chance to improve. After patients are well enough, the Impella pump can be removed via a minimally invasive procedure.
If you or a loved one is looking for comprehensive heart care, trust the team with the experience and tools to save lives and provide ideal outcomes. Call Call844-600-5151 or visit PepinHeartTampa.com for an appointment at the AdventHealth Pepin Heart Institute.