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Small Device Pumps New Life into Patients
By Dawn Sagario-Pauls | Photography by Tim Abramowitz
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The Impella Heart Pump

The Impella device comes in two sizes: one pumps 2.5 liters of blood per minute; the other pumps 5 liters of blood per minute. The smaller size is more commonly placed in patients in the cardiac catheterization lab, according to Jo Kajewski, an Impella specialist with Abiomed, manufacturer of the device.

Inserting the Impella takes 10 to 15 minutes, Bert Iannone, M.D., says, and the procedure can usually
be done using local anesthesia.

The Impella is a newer option to the intra-aortic balloon pump, which has been in use since the late 1960s, Dr. Iannone says. The Iowa Heart Center was the first in the state to use the Impella and has placed about 20
of the devices so far.

One advantage of the Impella is that it is more
efficient when compared to the intra-aortic balloon pump, which pumps 0.4 liter of blood a minute, Kajewski says. Also, the Impella can be inserted
through the groin or an arm; the intra-aortic pump must be placed via the groin.

Patients with the Impella device also do not have to take specific heart drugs that are required for those with an intra-aortic balloon pump, which can tax the heart even more, Dr. Iannone says.

Drawbacks of the Impella include its size (the intra-aortic balloon pump is smaller). The Impella’s larger size increases the risk of bleeding complications at the site in the groin through which the device is inserted, Kajewski says.




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Nancy Meacham calls her husband a “miracle man.”

“He truly, truly shouldn’t be here,” she says of Allan Meacham, to whom she has been married for 22 years.
On February 1, 2010, Allan was battling for his life at Mercy Medical Center – Des Moines. He was suffering from severe heart disease, according to Bert Iannone, M.D., and his heart was rapidly failing, functioning at only 20 percent.

“He was literally dying right on the table,” says Dr. Iannone, an interventional cardiologist and director of the Cardiac Catheterization Laboratory at Mercy Medical Center – Des Moines.

Then the doctor placed the Impella heart pump in Allan. It saved his life, Dr. Iannone says.

The new Impella device, about the size of an ink pen, helps a failing heart keep pumping blood into the body. It works like a boat propeller by creating a sucking effect, pumping blood from the heart’s left ventricle into the aorta at a rate of up to 2.5 liters per minute. The Impella helps the heart rest and recover.

Used in acute situations, the device can be left in the body for two to five days, depending on the patient’s condition. Individuals who have had a heart attack comprise some of the Impella patient population; other recipients include those with heart failure or those who have been turned down for heart surgery.

According to Dr. Iannone, “Allan needed this for a short period of time to get it turned around. I’m certain he would have died without the Impella.”

Total system failure

Allan Meacham just hadn’t been feeling like himself.
He had been short of breath for several weeks leading
up to that harrowing day last February. That wasn’t typical for Allan, a healthy guy who had been doing the physically demanding tasks of working on electrical transmission lines for more than 30 years. He chalked it up to a bad cold or bronchitis.

“Every once in awhile, I felt like I was winded,” says Allan, 59, from rural Redfield, Iowa. “I would stop and take a break and I would be OK. As long as I sat down or relaxed, it didn’t bother me. But that wasn’t normal for me.”
Then on February 1 things quickly took a turn for the worse while he was helping his son carry some beds.

Unable to catch his breath, Allan went to see his doctor in Des Moines, who immediately sent him to the emergency room at Mercy. Something was wrong with his heart.
The plan was to do an angioplasty, says Nancy. The
procedure entails using a tiny balloon to open clogged heart arteries. But Nancy recalls Allan turning a frightening blackish-blue color as Dr. Iannone came into the hospital room.

“He got really panicky and he started feeling really hot. They literally ran him down to the cath lab,” Nancy says.
There Dr. Iannone placed the Impella device into Allan’s heart, which stayed there for a few days.

He wouldn’t be here today without the Impella, Nancy says. “The amazing thing was that he didn’t have to be on it very long.”

But Allan wasn’t out of the woods yet. A short time
after the procedure, Nancy says, her husband started having problems breathing and was put on a ventilator. His heart was going into atrial fibrillation, erratically “quivering” instead of pumping. His heart stopped beating twice and needed to be shocked back into a normal rhythm. Allan also had to be put on a 24-hour dialysis machine for about two weeks,
she says.

“It was total system failure,” Nancy recalls. Allan was in Mercy’s Cardiac Intensive Care Unit for about two weeks, finally released to go home on February 19. After he was discharged, Allan continued dialysis for some time and for about a month had to wear a special vest that would shock his heart back into rhythm if it went into atrial fibrillation again.

About a month after he came home, his heart function
was up to 45 to 50 percent, and Allan no longer needed the defibrillator/pacemaker doctors had planned for him.
Dr. Iannone says the cause of Allan’s heart disease, or
cardiomyopathy, remains unknown. Allan says he did not have a personal or family history of heart problems.
The whole ordeal is a blur for Allan, who remembers
just bits and pieces of his stay at the hospital. Much has changed in his life since last February. One of the biggest adjustments was leaving behind his career as a line worker.

He’s now in a less strenuous job, working as an assistant
business manager with the International Brotherhood of Electrical Workers, Local 55, in Des Moines.

In addition, Allan has tweaked his diet and now uses
alternative seasonings instead of salt. He’s also reduced his fat intake, tries to moderate his physical activity, has given up drinking, and takes medication to help his heart stay
in rhythm.

Allan feels lucky to be alive and has high praise for
Dr. Iannone.

“I feel pretty fortunate,” he says. “I’m sure glad I got him for a doctor. He’s number one in my book.”




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