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Cardiac care

Rotary pumps used at New Brunswick Heart Centre

By Dr. Marc Pelletier

SAINT JOHN, N.B. – The New Brunswick Heart Centre, part of Horizon Health Network, has a new tool for saving lives and it fits in the palm of your hand. When a heart is weak or failing, the top priority for any cardiac team is to keep blood flowing. The Abiomed Impella Percutaneous Circulatory Assist System uses leading-edge technology to do just that.

The Impella, recently purchased for the Centre by the Saint John Regional Hospital Foundation, is helping to save lives. The Impella – the first system of its kind used in Atlantic Canada – consists of a tiny rotary pump that is threaded into the heart.

When a person’s heart has failed, the pump drives blood through the body by sucking blood out of the left ventricle and sending it to the aorta. The pump can move up to five litres of blood per minute, relieving the workload on a damaged or weak heart and improving flow throughout the body until the heart heals or is repaired.

The Impella can be put to use very quickly. Trained staff in a regular catheter laboratory setting can usually insert the device within 30 minutes. In cases where time is of the essence, this device can be ideal.

The Impella has already had a significant impact at the New Brunswick Heart Centre. Soon after the Impella became available, it was used to assist one patient during a high risk angioplasty.

The patient, who was in his 60s and suffered from heart failure, kidney failure, and chronic leukemia, was too sick for cardiac surgery, with a mortality risk of greater than 30 percent. By using the Impella to assist the heart, the New Brunswick Heart Centre’s team was able to complete a successful stent of the main coronary artery. The device was then removed; the patient returned to the nursing unit for routine care. Within days, the patient was back at home.

In another case, a patient was dying due to the effects of a heart attack. In a 12-hour period, the patient needed to be shocked and resuscitated over 50 times. By using the Impella, the cardiac team stabilized the patient. The patient was safely transported to Dalhousie University to undergo heart transplant assessment and has not required any further shocks or resuscitation.

These two cases are typical of the scenarios when the Impella can be used. People who are eligible for this procedure are often among the sickest cardiac patients, including those who would likely die without this particular form of mechanical support.

While about a quarter of tertiary cardiac centres in Canada use the device, Horizon Health Network’s New Brunswick Heart Centre is the first in Atlantic Canada to offer this kind of minimally invasive circulatory assistance technology. The Heart Centre expects that up to five or 10 patients per year may require this type of advanced support – patients who previously would have had few other options.

For its part, Horizon Health Network is the largest health authority in Atlantic Canada and one of the largest in Canada. One of New Brunswick’s largest employers, Horizon has 14,000 staff and 1,000 physicians. Its over 100 facilities serve New Brunswick, northern Nova Scotia and Prince Edward Island.

Horizon Health Network has provincial responsibility for some tertiary healthcare services and a number of unique provincial programs. The New Brunswick Heart Centre, located in the historic harbour city of Saint John, is one of these.

Horizon is also home to the Dalhousie Medicine New Brunswick distributed medical education program, based in Saint John, and delivered in locations throughout Horizon’s region.

Dr. Marc Pelletier is the Clinical Department Head, Cardiac Surgery, New Brunswick Heart Centre, Horizon Health Network.

Posted October 21, 2010