Patterico's Pontifications

3/22/2008

Healing the Heart

Filed under: Miscellaneous — DRJ @ 6:33 pm



[Guest post by DRJ]

Here’s an amazing article with medical news about the heart that doesn’t involve transplants or stem cells:

“At 28, Salina Gonzales had one month to live. Her heart, swollen to nearly the size of a coconut, could only pump a trickle of blood.

As the schoolteacher from San Antonio lay dying in a Houston hospital in late summer 2006, she worried as much about her toddler’s future as her own. Her best hope, a transplant, didn’t seem practical. What chance was there of finding a new heart in such a short time?

Even that option didn’t offer true salvation, because the average heart transplant patient lives just a decade or so. Gonzales might see her son, Scott — then not even 2 — grow into his teens. But she probably would never watch him walk across the stage for his high school diploma.

So, Gonzales opted for an experimental therapy: She allowed Houston physicians to drill into her heart and implant a propeller-driven pump. Gonzales was young, her doctors said. There was a chance that, if given a breather, her heart might recover on its own.

It did. Eleven days ago, a surgeon at [Houston’s] Texas Heart Institute removed the pump. A few days later, Gonzales walked a mile around hospital corridors — with her own heart, once given up for dead.”

This is a good story for Salina, her family, and hopefully many others like her.

— DRJ

2 Responses to “Healing the Heart”

  1. These pumps have been around for a while; the “HeartMate XVE” mentioned in the article won FDA approval some years ago. It’s a mechanical pump with pulsatile flow, i.e. it beats as does a functional heart.

    Gonzales got a “HeartMate II,” which despite the similar name is a completely different device. The cool thing about it is that it is a continuous-flow pump. This makes it much easier to design and build from an engineering point of view. It’s smaller and more reliable.

    With the first-generation XVE (and similar therapies), the assumption was that a heart-failure patient needed pulsatile flow, because continuous flow doesn’t give the arteries the once-a-second stretching that they need. This is indeed true. The surprising insight of a couple of years back was that when a continuous-flow pump is implanted, the beating of even a very damaged heart (such as Gonzales’) will add enough pulsation to satisfy the requirements of the arteries.

    The added kicker that Gonzales’ case illustrates is that some patients in the gravest stage of heart failure can recover significant cardiac function, if their own heart is relieved of much of the burden of pumping blood for some weeks or months. Until 2006 or so, it had been assumed that such extensive damage (called NYHA Stage IV) was pretty much irreversible.

    The company that makes these pumps, Thoratec, is working towards getting FDA approval for the HeartMate II for permanent implantation (protocols for removal as outlined in the article are still experimental).

    It should also be noted that while the pump itself is small, it must be connected to a largish pack that is outside the body, containing the pump’s computer controller and power source. So HeartMate II represents good progress but is not a panacea.

    …More than you ever wanted to know about implantable pumps…

    AMac (b703da)

  2. This is a great story, especially for this time of year.

    A quick Google search though, showed no mention of this at NYT, or MSNBC (I would think Keith would be all over this, the great humanitarian that he is). To its’ credit, ABCNews did carry it – it couldn’t be a Disney Film-of-the Week project, could it?

    I wish Ms. Gonzales well, and look forward to her witnessing her son’s graduation – HS & College!

    Another Drew (8018ee)


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