State-of-the-art Technology Keeps Hearts Pumping: The Impella CP® Ventricular Device

Christian Hospital’s cardiology team is ready to take care of the sickest of patients. One of the capabilities allowing them to do so is the Impella CP® ventricular assist device. In use for about 10 years at Christian Hospital, this innovative device allows interventional cardiologists to perform heart procedures on patients with the most severe cases by keeping their hearts pumping.

WHEN IS IT USED?

The ventricular assist device is employed during the duration of high-risk heart interventions and throughout recovery. “It is useful for very sick patients who present with a heart attack to which the damage to the heart muscle is so severe that it is unable to pump enough blood. This results in cardiogenic shock, meaning blood pressure is low and perfusion of blood flow to the body is very compromised,” says Deepak Koul, MD, FACC, an interventional cardiologist at Christian Hospital.

While it is commonly used in emergency events, the device can also be used in elective procedures. Extensive blockages of the heart or a severely damaged heart muscle can be particularly concerning during any heart procedure, and the device can be beneficial for these patients in life-threatening conditions.

HOW DOES IT WORK?

When the cardiologists are at work removing blockages or performing other high-risk repairs, the device provides mechanical support to help pump blood from the heart, relieving the stress on the heart muscle. “It takes the function of the heart for the duration of time, helps maintain perfusion to the vital organs and allows the damaged heart muscle to recuperate or heal,” says Dr. Koul. “Also, in high-risk interventions, it gives us breathing space while working on the heart.”

The device is usually inserted through a catheter in an artery in the groin called the femoral artery. It is then placed in the left lower chamber of the heart, under X-ray guidance. Echocardiogram is also used to monitor for continued proper device placement. The device is removed once heart function improves, which may be from hours to a few days while the patient is recovering. Because it is inserted in a minimally invasive way, recovery can be relatively easy for the patients.

Over the last 10 years, the cardiology team has seen great success with the use of this device. Recently, Christian Hospital also received approval for use of the Impella 5.5®, in addition to the Impella 5.0®, which are larger heart pumps placed by cardiothoracic surgeons for greater heart support. “We have had great outcomes with some of the very sick patients over the years. These devices have been very beneficial to many of them,” says Dr. Koul. “It’s a great service we can provide to the patients as part of our comprehensive cardiovascular program.”

To learn more about Christian Hospital’s comprehensive heart care, please call 314.747.WELL (9355).

IMPELLA IN ACTION

In July 2020, Larry Cates, 65, of Collinsville, Ill., had a heart attack. He was admitted at a local hospital and placed under the care of Dr. Koul, who also practices at Christian Hospital. Given Larry’s rapidly declining condition due to cardiogenic shock, Dr. Koul and his team decided to insert the Impella CP® ventricular assist device to keep his heart pumping before he could be transferred to Christian Hospital for more extensive treatment.

Once there, it became clear Larry needed greater heart support. Shuddhadeb Ray, MD, MPHS, a Washington University cardiothoracic surgeon, replaced the Impella CP® with the larger heart pump, the Impella 5.0®. This stabilized his condition, allowing Dr. Koul to perform an emergency coronary intervention in which four stents were placed. Larry woke up in the ICU several days later. Because he is blind, this experience brought even more trepidation, but Larry could not have been more impressed with the care he received.

Now, Larry is doing well. He has joined a gym and returned to his normal activities before the heart attack. There is no damage to his heart, and it is functioning well. He even returned to Christian Hospital to bring doughnut holes to the ICU and 9th floor, where he was cared for, as a gesture of gratitude to the team that saved his life.

“The treatment I had at Christian Hospital was unbelievable. They saved my life — no doubt about it. I would recommend them in a heartbeat.”

-Larry Cates, Christian Hospital heart patient