New Delhi ,
Patient with cardiogenic shock successfully revives to life at Fortis Escorts Heart Institute, Okhla, New Delhi. The center of excellence in cardiac care, performed “Protected Angioplasty and stenting procedure” to save a patient with multiple life threatening blockages by using the India’s first miniature heart pump ‘Impella’.
It was a case of 55 year old male, type-2 diabetes mellitus, coronary artery disease, triple vessel disease with severe LV dysfunction (EF: 20%). Patient was admitted at Fortis Escorts heart Institute with complaints of chest pain and breathing difficulties on 31/12/2018. He was admitted in Critical Care Unit (CCU), managed medically (On the line of heart failure management). After stabilization he underwent coronary angiography which revealed triple vessel disease. He needed early revascularization, however, surgery could not be performed as it was very high risk case. Then it was decided to go for Impella guided angioplasty. Angioplasty was performed with the help of Impella and now the patient recovered well after procedure and he was discharged. Presently patient is doing fine at home.
“The device supported the heart admirably to keep the patient stable throughout the very complex angioplasty procedure and afterwards for recovery. It was an extreme high risk angioplasty which was successfully performed without any complications with good supply of blood being maintained to the Kidneys and Brain. It has been proven to support the heart to improve safety of the procedure and improve outcomes. When the procedure is over or the heart recovery occurs, the device can just be pulled out and removed as it is like a catheter. It is approved in and has been used in USA and Europe for the last few years and has been introduced into India now. “ said Dr Vishal Rastogi, Head – Heart Failure Program, Fortis Escorts Heart Institute, Okhla, New Delhi
Making use of the miniature heart pump ‘Impella’, the hospital is the first in India to offer such new and advanced life saving treatment for failing heart patients. The new ‘Impella Device’ is the ‘World’s Smallest Heart Pump’, which can support a failing heart for upto 7-days and occasionally longer when patients are at a higher risk for surgery and left with no other alternative.
In a recently conducted CME at Cosmos Hospital, Dr Vishal Rastogi discussed the various aspects of intervention like Percutaneous transluminal coronary angioplasty (PTCA) in management of difficult lesions in Coronary Artery Disease (CAD). The CME was conducted on the occasion of installation of advanced flat panel GE Cath lab in the hospital. With advancements in the field of cardiac interventions, Fortis Escorts Heart Institute, Okhla recently performed a miniature heart implant angioplasty, which is first in the country.
This marks the beginning of the first “Heart Recovery Program” in India, where the device can help the patient’s own diseased and weak heart to rest, recover and function on its own.
The Impella Heart Support pump can support the heart function and give rest to the heart in cases of cardiogenic shock after heart attack, myocarditis, post cardiotomy till heart can recover by drugs or through supported angioplasty. In patients with multiple blockages and/or depressed heart function, who are high risk for surgery, protected angioplasty and complete revascularization of multiple blockages with the support of Impella can help recovery of heart function and improve survival.
“It would have not been impossible to do the procedure with safety without the support of Impella device. This landmark is the start of the first “Heart Recovery Program” in the country where patient with weak hearts and cardiogenic shock can be supported at angioplasty or in CCU to allow heart to recover by implanting a miniatured catheter based heart pump, without surgery. The device can also be used to transport patient in shock to tertiary centers where advanced treatment can be instituted to help survival.” Added Dr Vishal Rastogi, Head – Heart Failure Program, Fortis Escorts Heart Institute, Okhla, New Delhi
The ‘Heart Recovery Programme’ entails the concept of supporting the failing heart through a period with a heart support device to allow it to recover and function on its own ultimately. If the patient’s own heart recovers and functions well then not only is it the ideal option for the patient for his quality and longevity of life but also has the potential to save healthcare costs. It differs from other left ventricular assist devices, which are mainly artificial hearts, are a bridge to transplantation, expensive and involve major surgical procedure for implantation.