NS-LIJ docs to the rescue with new heart pump

North Shore-LIJ doctors saved the life of a 74-year-old patient late last month using a tiny motorized device – just approved by the FDA – that boosts heart function in patients who suffer what’s called cardiogenic shock following a heart attack.

The device, the Impella RP, is billed as “the world’s smallest heart pump” by its maker, Abiomed of Danvers, Mass. The Impella received FDA approval in January.

“Options that were available prior to this were really drugs or surgical interventions with machines that take over the work of the lungs and heart,” said Dr. Rajiv Jauhar, the chief of cardiology at North Shore University Hospital. “These types of approaches took time and manpower when time was of the essence.”

North Shore-LIJ cardiologist Dr. Rajiv Jauhar: Six months ago, the outcome would have been decidedly different.

North Shore-LIJ cardiologist Dr. Rajiv Jauhar: Six months ago, the outcome would have been decidedly different.

“The bottom line was many patients were too sick for these interventions and by the time we mobilized the surgical team it could take two to three hours, and so we just tried to ride it out with just medications, and it didn’t really work in a majority of our patients.”

The female patient had a right-sided infarction, meaning the right-side of her ventricle had a hard time pumping blood into the lungs to be oxygenated. She also had a blocked right coronary artery and dangerously low blood pressure.

“What the Impella device has a motor on it which takes blood from the large vein outside the heart and forces the blood into the lungs,” said Jauhar. “It essentially bypasses the right ventricle completely.”

Jauhar, along with Dr. Perwaiz Meraj, an interventional cardiologist, and an advanced hemodynamic team implanted the device through a catheter that required only a small hole in the patient’s leg. The device can remain in a patient for up to 14 days, as the heart begins to stabilize on its own.

“She got markedly better within a matter of a few minutes,” said Jauhar, who also installed a stent into her right coronary artery to open it.

“This is a dramatic innovation because it allows an interventional cardiologist to take care of very sick patients under dire time constraints to fix a blockage and also support the patient in the critical phase that they are in.”