Ocala Regional Medical Center has introduced new minimally invasive technology that helps patients' heart pump blood during surgery.
Ocala Health — which includes the medical center and West Marion Community Hospital — announced on April 10 that physicians performed their first successful surgery in February using the Impella device. Since then, there have been four more operations using the device, all of which have been successful.
Impella, a small heart pump, supports the patient’s heart during high-risk procedures by increasing its ability to pump blood, said Dr. Prem Singh, Ocala Health's cardiac catheterization laboratory medical director, who was involved in two of the five Impella procedures.
The idea is that patients who have weaker hearts and may not be physically able to undergo more invasive procedures can get the care they need because of the lowered risk provided by Impella.
“This device will give us more opportunities and more room to take care of those more complex patients, and the doctors are more confident here now taking care of patients,” Singh said.
Dr. Jigar Patel, an Ocala Health interventional cardiologist, said he believes the most successful procedure so far was on a 71-year-old patient.
“She had three vessels that were 100 percent blocked. Her heart was very weak, [but the procedure] turned out very well,” Patel said. “We used six stents to open up all the blockages, and I saw her for a follow-up and she’s feeling much better.”
Impella is a percutaneous device, meaning that a patient's chest doesn't have to be opened up at her or his heart during surgery.
“The normal heart has 5 to 6 liters [of blood] pumped per minute,” Singh said. “So some patients – their heart pumping is very bad and very low. So when we put in this Impella device, it increases the heart’s output by 2.5 liters.
"That way, we can fix blockages, and the patient’s long-term outcome is really good.”
Impella is inserted through a catheter in the patient’s groin, so after the procedure, doctors have to stitch only at the insertion site, making for a much shorter recovery. Singh said many patients are able to go home the day after their procedures.
It is the only FDA-approved percutaneous hemodynamic (blood circulation) support device determined to be safe and effective for the treatment of high-risk patients, according to Ocala Health.
There are different variations of the device. Ocala Regional Medical Center uses the Impella 2.5, named after the 2.5 to 3.5 liters of blood per minute it pumps for the heart during surgery, said Michelle Hodges, a cardiovascular service line administrator at Ocala Health.
By comparison, the balloon-pump technology Ocala Health used before pumped only half a liter of blood per minute — five times less than Impella.
The hospital chose the device because it works best for percutaneous coronary interventions, non-surgical procedures that improve blood flow to the heart by opening blocked coronary arteries.
“We essentially restore the blood flow that feeds the heart muscle,” Hodges said. “And now because the heart muscle is getting blood and oxygen, it’s able to recoup to a normal pumping capacity.”
Although Ocala Health physicians are using Impella just for high-risk percutaneous coronary interventions right now, Patel said the goal is to start also using it for heart-attack and cardiogenic-shock patients within the next month.
“Once everything’s set, we’re going to offer this device to people who come in with heart-muscle pump failure and hope that they are able to make it through the heart attack until we can offer them some kind of definitive therapy,” Patel said.
There are now four physicians working in the medical center's catheterization lab who are trained to utilize Impella, but the hospital is working to expand that number.
It's planning to set up a mobile learning lab on April 24 that will allow physicians and staff from the catheterization lab and cardio-intensive care to learn about and practice with the technology.
“We continue to expand our cardiovascular service and our ability to implement technology, which allows us to take care of high-risk patients and provide those patients with a great outcome,” Hodges said. “That is what we’re doing here, and Impella is just our latest technology that will help us do that.”