As medical technology advances, physicians are able to treat high-risk patients who may not have been candidates for procedures in the past. The Impella® heart pump simulator is a great example of how a minimally invasive device helps cardiologists treat their sickest patients.
The Impella® heart pump simulator is a new heart support technology that is used to assist the pumping of the heart during certain procedures and to treat patients in cardiogenic shock. This breakthrough technology is offered at the St. Vincent's Birmingham and St. Vincent's East hospitals. "St. Vincent's was one of the few health systems selected, and the only one in Birmingham, to have an in-depth look at this cutting-edge technology with a special learning lab training opportunity," says Gordon Wesley, Administrative Director for Cardiovascular Services for St. Vincent's Health System.
E. Merritt Cullum, MD
The Impella® heart pumps are approved by the FDA to provide treatment during elective, high-risk percutaneous coronary intervention (PCI) procedures and in the emergent treatment of cardiogenic shock. "In the past, many of these patients did not survive, but this pumping device is saving lives," says E. Merritt Cullum, MD, a cardiologist at St. Vincent's Birmingham. "It is inserted into a patient's left ventricle, the main pumping center of the heart, and pumps blood into the aorta. It also supports the left ventricle in high-risk stenting procedures for patients with a severely weakened heart muscle. We use it in patients who are having a heart attack and are in cardiogenic shock to help generate an adequate blood pressure to supply blood throughout the patient's body."
Impella® pumps are left ventricular assist devices that are placed in the leg instead of the heart muscle. Prior to the development of the Impella® pump, the only option for these patients was an intra-aortic balloon pump (IABP). "The IABP has applications, but not in high-risk patients," Cullum says. "The risk of dying from cardiogenic shock during a heart attack is high unless you aggressively correct the low blood pressure quickly. That is what this device does. I always say that the difference between an IABP and an Impella® device is like the difference between a Yugo and a Ferrari. Both are cars, but that's where the similarity ends. Both of these devices are cardiac devices, but in very sick patients, the Impella® pump is an absolute life saver. I have seen many patients who would not have survived without it."
The various Impella® heart pumps have supported more than 50,000 patients in the United States. The Impella 2.5®, Impella CP® and Impella 5.0® are FDA-approved heart pumps used to treat heart attack patients in cardiogenic shock and have the unique ability to enable native heart recovery, allowing patients to return home with their own hearts. The Impella 2.5 and Impella CP devices are also FDA approved to treat certain advanced heart failure patients undergoing elective and urgent percutaneous coronary interventions (PCI), such as stenting or balloon angioplasty, to re-open blocked coronary arteries. The Impella RP® device is approved to treat certain patients experiencing right-side heart failure.
According to Cullum, the only downside of the device is its large size, but the benefits far outweigh this. "I haven't found the size to be a problem so far," he says. "It puts a large hole in the artery, but when done correctly, it has great benefit to the patient."
In addition to its ability to save the lives of critical patients, the Impella® heart pump simulator can support a patient's blood pressure adequately without medication. In the past, physicians treated these patients intravenously with vasopressors, medications that artificially support a patient's blood pressure while the heart heals. Those medications can negatively affect kidney function and other parts of the body. "The Impella® device is the most physiologically natural way to support blood pressure in patients who have had a severe heart attack and cardiogenic shock," Cullum says.
He says that St. Vincent's cardiologists and cardiovascular surgeons use the Impella® devices and work together to provide a team-based approach that is best for each patient. "This is another tool in our toolbox that we can use to help ensure our patients get well."
- Merritt Cullum, MD