Image credits: Asian Age

Age matters when it comes to surgeries. 86 years and 90% blockage in all arteries! That was the reason that no one was willing to operate an old man from Delhi. The man had 90% blockage in all arteries with severe calcium composition. But thanks to the doctors of Fortis Escorts Heart Institute (FEHI, Delhi). A team of doctors led by Cardiovascular Sciences chairman Ashok Seth managed to conduct angioplasty on the 86 year old patient and claimed to perform the country’s first successful protected angioplasty and stenting procedure with the help of the Impella heart pump. The process involves clearing the blocked arteries of the calcium deposition by drilling and placing stents in them for proper blood flow.

The Impella device is the world’s smallest heart pump which can support a failing heart for seven days, even longer occasionally. It acts like a catheter and works on the principle of a submersible water pump. It is as thick as a pencil and approximately 6-inch long. While other devices need to be implanted via a surgical procedure, the Impella heart pump can be inserted into the heart without undergoing any surgical procedure.  It is used to help maintain stable heart functions and ensure blood flow is maintained to organs like the brain and kidneys in cases of cardiogenic shock or during risky angioplasties. Once in position, the device withdraws blood from the left ventricle and expels it in the ascending aorta, the same effect that happens with the pumping motion of the heart.
The 86 year old patient came with severe recurrent chest pains over a week and menacing heart attack. An angiogram revealed that all his arteries were over 90% blocked with very hard calcium deposited on them. Since he is aged, it was impossible to conduct angioplasty without the help of a pump.
“This marks the beginning of the first heart recovery programme in India. The device helps the patient’s diseased heart to rest, recover and function on its own. The Impella can support a failing heart [cardiogenic shock] due to heart attack or myocarditis for seven days or even longer till heart recovers. It can be used to support the heart in cases of high-risk angioplasties [protected PCI] in patients with poor heart function and where surgery is considered risky.” It has proven to support the heart to improve the safety of the procedure. Once the procedure is over or the heart recovers the device can be removed like a catheter. It has been approved and is used in the US and Europe for the past few years.” he added.
Also, a release issued by the hospital states that “…this new life-saving treatment is for patients suffer from high-risk blockages and a failing heart, who are at high risk for surgery and angioplasty, and often left with no options.”
Though there are other devices available to support the heart function mechanically, they are costly which may cost around 70 lakh, while the Impella pump costs about Rs 15 lakh.

Source: The Hindu, ET Healthworld.