My heart will go on ...

Heart pumps are en­rich­ing the lives of end-stage heart pa­tients.

The Star Malaysia - Star2 - - R.AGE - By SHERRY JA­COB­SON

Heart pumps are en­rich­ing the lives of end-stage heart pa­tients.

TECH­NI­CALLY speak­ing, Al Sen­ter died al­most two years ago. But there he was re­cently, un­de­ni­ably alive, climb­ing up and down a lad­der, trim­ming the bushes around his Flower Mound, Texas, home.

The 78-year-old hasn’t had a pulse since June 10, 2008, when he was among the first pa­tients in the US to re­ceive a me­chan­i­cal heart pump for treat­ment of end-stage heart fail­ure.

The surgery, part of a clin­i­cal trial at Med­i­cal City Dal­las Hos­pi­tal, re­placed his pulse with the con­stant whir of a small me­chan­i­cal pump im­planted in his ab­domen. The pump is at­tached to his heart to help sup­ply his body with a con­tin­u­ous flow of oxy­gen-rich blood.

“If you lis­ten to my heart with a stetho­scope, you’ll hear a good steady hum, which means it’s work­ing fine,” Sen­ter said.

Be­fore he got the de­vice, Sen­ter was liv­ing a mostly seden­tary life, with barely enough en­ergy to get out of bed or chew a few bites of food.

His re­mark­able come­back has turned him into a vir­tual walk­ing and talk­ing pro­mo­tion for the HeartMate II Left Ven­tric­u­lar As­sist Sys­tem – made by Tho­r­atec Corp. of Pleasan­ton, Cal­i­for­nia.

In Jan­uary, the US Food and Drug Ad­min­is­tra­tion ap­proved the use of the pump for ad­vanced heart fail­ure pa­tients like Sen­ter.

As few as 20,000 or as many as 500,000 Amer­i­cans, most of them el­derly, could ben­e­fit an­nu­ally from the pump or fu­ture ver­sions of it.

“The pool of peo­ple is very large and, cer­tainly, larger than we would hope to do on a yearly ba­sis,” said Dr Todd Dewey, a cardiothoracic and trans­plan­ta­tion sur­geon.

In Sen­ter’s case, his heart had failed de­spite his best ex­er­cise habits, cut­ting-edge drug ther­apy, and a pace­maker-de­fib­ril­la­tor im­planted in his chest.

His last re­sort would have been a heart trans­plant, but he was too old to qual­ify by the time he re­ally needed one.

“My doc­tor thought I was near death,” Sen­ter re­called of his life be­fore the pump. “I could get out of bed, have break­fast and spend the day in my re­cliner.”

Three med­i­cal cen­tres – Med­i­cal City, UT South­west­ern and Bay­lor Uni­ver­sity – be­gan of­fer­ing the HeartMate II pump to end-stage heart-fail­ure pa­tients this year.

As word has spread, more and more car­di­ol­o­gists are re­fer­ring pa­tients for as­sess­ment.

Last year, Med­i­cal City im­planted 24 heart pumps, and Dewey said he ex­pects to do as many as 40 this year. “We’re the last-ditch ef­fort for a lot of these peo­ple,” he said.

More than five mil­lion peo­ple in the US have been found to have heart fail­ure, a long-term chronic prob­lem that con­trib­utes to 300,000 deaths a year, ac­cord­ing to the Na­tional Heart, Lung and Blood In­sti­tute.

In many cases, heart-fail­ure pa­tients might have qual­i­fied for a trans­plant, but there aren’t enough donor hearts to go around – 2,500 or fewer a year. The trans­plant cut­off age is usu­ally 65 to 70.

Since heart pumps can be re­placed and may im­prove over time, they might be prefer­able to trans­plants, which last about 10 to 12 years, said Dr Dan M. Meyer, a cardiothoracic sur­geon.

Meyer im­planted 25 heart pumps at Bay­lor and UT South­west­ern last year and ex­pects to dou­ble that this year.

“Ev­ery­one is search­ing for a break­through treat­ment for end­stage heart fail­ure,” said Dr Roger W. Evans, a health­care con­sul­tant who spe­cialises in the eco­nom­ics of heart trans­plants and other end-oflife ther­a­pies.

“We don’t have the ideal pump yet,” he said. “But it’s mov­ing in a pos­i­tive di­rec­tion with 10 to 12 pumps in var­i­ous stages of devel­op­ment and use now.”

If the HeartMate II or any other heart pump is em­braced by doc­tors as an ac­cept­able stan­dard of care for se­verely ill heart pa­tients, Evans pre­dicted the cost of help­ing them will be­come an over­rid­ing is­sue.

“The whole idea of cut­ting spend-

Newspapers in English

Newspapers from Malaysia

© PressReader. All rights reserved.