It is always a challenge for the doctors to perform any procedure on a patient having several bad parameters. One such patient, a 62-year old woman, having diabetic polyneuropathy with lot of pain, having weak heart, diabetes, living with three stents inside, having severely leaking valves, was saved by a city cardiologist after using a unique Impella device without surgery. Six months since the procedure, the woman is absolutely fine. The procedure is called ‘Protected Angioplasty’. The new ‘Impella’ device is world’s smallest heart pump and works on the principle of submersible water pump. Unlike other devices, the Impella can be inserted into the heart without operation through the groin artery (Femur) in the catheterisation lab. It basically works as a maintenance unit when a cardiologist performs the procedure. While performing the procedure, the heart’s function should not get affected. It disturbs the doctors and on several occasions, it was found that, heart got arrested and patient died.

 

 

Impella, which is a USFDA-approved device, allows the heart to rest and recover by temporarily assisting the pumping function of the heart to efficiently deliver the blood and oxygen to the entire body. The Impella can support a failing heart due to heart attack or myocarditis for upto 7 days till the heart recovers. The 62-year-old diabetic woman, having undergone multivessel angioplasty with stenting in 2018, approached noted Interventional Cardiologist Dr Prashant Jagtap at Viveka Hospital. She was suffering from chest discomfort and severe breathlessness on admission to the hospital. Her angiography revealed blockages in the previously inserted stents in two major arteries of the heart. To save her, the Impella device was placed in the left chamber of her heart (left ventricle) through the right groin (right femoral artery). IVUS (Intravascular Ultrasound) guided angioplasty was conducted on right and left coronary artery. While performing angioplasty, a novel technique of cutting balloon initially followed by Drug Eluting Balloon (DEB) was used. The procedure lasted for one-and-a-half hours. The balloons from inside and Impella device were taken out. As the drug was put inside the artery through the balloon, no outside matter was put inside her heart.

 

The patient’s health improved after the procedure. She was discharged from the hospital after a couple of days. An Echo cardiogram repeated after six weeks revealed improvement in heart function and the valve leakage has also reduced significantly. The patient is stable and asymptomatic from cardiac standpoint now. “This marks the beginning of Heart Recovery Programme in Vidarbha and Chhattisgarh region where the device can help the patient’s diseased and weak heart to rest, recover and function on its own. We are glad, the patient is doing well and hopefully, in coming years, this treatment modality will become more accessible and affordable for all such high risk heart patients,” said Dr Prashant Jagtap, Senior Interventional Cardiologist, Viveka Hospitals while talking to ‘The Hitavada’. The procedure was performed by Dr Prashant Jagtap, Senior Interventional Cardiologist, Viveka Hospitals. He received assistance from Proctor Dr Pravin Chandra (New Delhi) regarding the operation of Impella device. The multi disciplinary team of doctors included Dr K G Jayaprasanna, Dr P Chaudalwar, Dr Ajay Sakhare, Dr Nikhil Balankhe, Dr A Modak, Dr D Deshmukh and Dr N Mathankar. Cathlab supporting team comprised M Tipale, U Alone, Rakhi, Rohan and Kalpana.