Sarasota Edition

Tiny Medical Devices Help Solve Big Heart Problems

By Rick Weirzbicki, Administrative Director of Cardiovascular Services

Tiny Medical Devices Help Solve Big Heart ProblemsFor people with certain heart conditions, open-heart surgery was once the only recourse.

Today, advances in surgical techniques and tiny medical devices allow doctors to use minimally invasive procedures to help patients with life-threatening heart problems.

At Venice Regional Bayfront Health hospital, the heart team uses minimally invasive surgical techniques to implant a variety of high-tech devices for monitoring and repairing heart problems.

TAVR for Narrowed Heart Valve
More than one in eight people aged 75 and older have moderate or severe aortic stenosis (narrowed heart valve), according to scientific studies. In the past, people suffering from the condition had limited options, such as open-heart surgery, to replace an unhealthy valve. TAVR is a less invasive approach, involving a small incision, typically in the groin area. A catheter is inserted into an artery and is guided to the heart to place the new valve.

TAVR is a viable option for patients who are moderate- or high-risk open-heart candidates. Benefits include shorter procedure and hospital stay times, relief of symptoms almost immediately, improved heart function, faster recovery, and less medication. Patients quickly experience improved energy, easier breathing and less stress. Patients who undergo this procedure experience a significant decrease in all-cause mortality compared to traditional valve surgery.

Impella® for Heart Failure
Cardiogenic shock is a condition in which the left ventricle of the heart fails to pump enough blood to the body, resulting in inadequate circulation, progressive severe damage to other organs, and even death. When patients with cardiogenic shock are not responsive to conventional treatment measures, additional short-term mechanical support of the circulation may be required.

Described as the world’s smallest heart pump, the Impella® system helps pump blood in patients who need short-term support (up to six days). The system includes a mini heart pump mounted at the end of a thin, flexible tube (catheter), a console that drives the pump, and an infusion system that flushes the pump.

Impella® helps pump blood by drawing blood out of the heart and pumping it into the aorta, partially or fully bypassing the left ventricle. It is implanted into the left side of a patient’s heart through a small incision in the femoral artery (major artery in the leg). It can also be implanted through a small incision in a subclavian artery (an artery in the chest).

Because Impella® acts as a blood pump that effectively bypasses the left ventricle, it supports blood pressure and provides increased blood flow to critical organs in patients with cardiogenic shock. This allows the left ventricle to rest and hopefully recover and resume pumping without support. Clinical evidence showed that 58 percent of patients with cardiogenic shock who received the Impella® device survived the procedure, and 67 percent of patients who left the hospital did not have another heart failure event within 30 days of the procedure.

WATCHMAN for Irregular Heartbeat
The WATCHMAN permanent heart implant device, which is implanted during a minimally invasive surgical procedure, offers an alternative to the lifelong use of blood-thinners for people with a common cause of irregular heartbeat that can lead to stroke.

WATCHMAN was designed for patients with atrial fibrillation not caused by a heart valve problem (also known as non-valvular atrial fibrillation). Atrial fibrillation, or AFib, affects the heart’s ability to pump blood normally. This can cause blood to pool in an area of the heart called the left atrial appendage, or LAA. There, blood cells can stick together and form a clot. When a blood clot escapes from the LAA and travels to another part of the body, it can cut off the blood supply to the brain, causing a stroke.

In people with AFib not caused by a heart valve problem, more than 90 percent of stroke-causing clots that come from the heart are formed in the LAA. That’s why closing off this part of the heart is an effective way to reduce stroke risk.

The WATCHMAN implant fits into the LAA. It’s designed to permanently close off the appendage. This will keep blood clots from escaping and future blood clots from developing in this area. WATCHMAN is about the size of a quarter and made from very light and compact materials commonly used in many other medical implants. WATCHMAN is implanted into the heart in a one-time procedure. It’s a permanent device that doesn’t have to be replaced and can’t be seen outside the body.

The WATCHMAN implant effectively reduces the risk of stroke, without the risk of bleeding that can come with the long-term use of warfarin (the most common blood thinner). WATCHMAN also can eliminate the regular blood tests and food-and-drink restrictions that come with warfarin. (Warfarin is also known as Coumadin®.)

In a clinical trial, nine out of 10 people were able to stop taking warfarin just 45 days after the WATCHMAN procedure.

CardioMEMS® for Chronic Heart Failure
CardioMEMS® is a permanent implant with sophisticated sensors to monitor cardiac function in patients with chronic heart failure.

Heart failure is one of the most common cardiac conditions in the nation. According to the American Heart Association, more than 5 million people in the United States suffer from heart failure each year. It is the number one cause of hospital admissions, and 50 percent of patients treated for the condition are readmitted to the hospital within six months.

Doctors at Venice Regional implant the CardioMEMS miniaturized, wireless monitoring sensor to reduce the risk of heart failure and hospitalization through earlier, more precise detection of symptoms. Physicians are able to monitor the patient’s vital signs remotely, reducing the need for office visits and allowing the medical team to intervene with changes to medication or lifestyle practices before an emergency situation can develop.

CardioMEMS isn’t just a tool for doctors, it helps to engage, educate and involve patients in managing their disease. The routine of taking regular readings encourages patients to participate in their own care. It heightens their awareness of factors affecting their health, such as how diet can impact their heart function.

Patients using the CardioMEMS system have 37 percent fewer hospitalizations, spend less time in the hospital, and report a better quality of life.

For more information about minimally invasive procedures for heart problems, call 941-483-7727.

Rick Weirzbicki is the Administrative Director of Cardiovascular Services at Venice Regional Bayfront Health.

Information from the U.S. Food & Drug Administration was used in this report.

All photos are courtesy of Venice Regional Bayfront Health.

Call 941-483-7727 or visit VeniceRegional.com

Rick Weirzbicki is the Administrative Director of Cardiovascular Services at Venice Regional Bayfront Health.

Information from the U.S. Food & Drug Administration was used in this report.

All photos are courtesy of Venice Regional Bayfront Health.

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