Get Pumped

The world’s smallest heart pump is now available at two of 417-land’s largest hospital

By Savannah Waszczuk

In the medical world, advances in technology can be lifesavers. The Abiomed Impella 2.5 pump, which is the world’s smallest heart pump, is an advance created with this exact intention. And lucky for us, it’s available at a couple of local hospitals.

St. John’s acquired the Impella 2.5 the end of 2009. Dr. David Cochran, who is an interventional cardiologist and section chairman of cardiology at St. John’s, says they expect to most often use the pump in two instances: in emergency situations, such as heart attacks, and on high-risk patients before stenting procedures.

“A common situation would be a patient who has ongoing heart attacks,” Cochran says. The Impella 2.5 helps the heart keep up. “The Impella device provides additional cardiac output to maintain blood flow to the body, assisting the weakened heart and providing support to maintain the circulation and preventing cardiogenic shock.” And when high-risk patients are concerned, the pump is electively or emergently placed to help take stress off the heart and keep it working throughout surgery.

Perhaps the most unique part of the Abiomed Impella 2.5 is the way it is placed in the body. It’s inserted percutaneously in the catheterization laboratory via the femoral artery into the left ventricle (read: it’s inserted in a very small skin incision in the leg), and the procedure only takes a few minutes. “The chest doesn’t have to be surgically open to put this in,” Cochran says. “And it can take 5 to 10 minutes, or less.”

At press time, St. John’s had installed two of the Impella 2.5 pumps, and Dr. Cochran did one of them. Before the pump was available, the intra-aortic balloon pump was used. “We’ve used it for years with a lot of success, but some patients are in such bad shape that it isn’t effective,” Cochran says. “Basically, the Impella is going to enable us to take care of patients who are in an even more serious condition.”

Cox Health also made the Impella 2.5 available for patients at the end of last year. At press time, Dr. James Ceaser, who is medical director of cardiology at Cox Health and an interventional cardiologist at Ferrell-Duncan Clinic, says the hospital had not yet used the device. “We thought it would fall somewhere between five and 10 uses a year,” Ceaser says. “When you have new devices like this, usually one of two things happens: It either works very well, and it is used more than you thought it would be, or the opposite—it doesn’t work as well and isn’t used as much,” Ceaser says. “It’s very common that it just sits there for a little while.” Cochran says St. John’s predicted it may help anywhere from 12 to 20 patients per year.

But regardless of how often it’s used, it’s very important that it’s available locally. “If you’re an institution that wants to do very advanced, aggressive cardiology, it’s probably the most recent advance in left ventricular support that [the institution] should have,” Ceasar says.