1 week ago
Mechanical Support Expands Options for High-Risk Cardiac Patients
Some people have hearts that are too weak to handle a difficult heart procedure.
Mechanical circulatory support devices can temporarily help move blood through the body.
Impella mainly helps the heart pump.
ECMO can support both the heart and lungs when a patient is extremely sick.
Doctors used Impella while treating an 83-year-old man with severely blocked and hardened heart arteries.
His symptoms improved and his heart function got better.
Another patient had a massive heart attack and cardiac arrest, so doctors used ECMO after an intra-aortic balloon pump was not enough.
He eventually left the hospital with improved heart function.
These treatments require experienced doctors, nurses and intensive-care specialists working together.
Mechanical circulatory support can temporarily assist patients with severe heart failure, extensive coronary disease or cardiogenic shock.
Impella supports the heart’s pumping function, while ECMO can support both the heart and lungs.
An 83-year-old man with severe multivessel disease and about 30% heart function improved after Impella-supported high-risk angioplasty.
A 69-year-old heart-attack patient received ECMO after cardiac arrest and remained critically unstable despite an intra-aortic balloon pump.
Specialist multidisciplinary teams and advanced infrastructure are essential for using Impella and ECMO safely.
- Who
- Patients with severe heart disease or cardiogenic shock, treated by specialist cardiac teams including Prof. Dr Babu Ezhumalai.
- What
- Mechanical circulatory support using devices such as Impella and ECMO is being used to support high-risk cardiac procedures and stabilize critically ill patients.
- Where
- The cases were treated at MGM Healthcare in Chennai; the article discusses expansion of access across India.
- When
- The article describes two recent clinical cases and notes that an associated pediatric case report was published in 2019.
- Why
- The devices can temporarily maintain circulation or reduce the heart’s workload when conventional support is insufficient, giving doctors time to treat the underlying heart problem.
Key facts
- Impella
- A temporary heart pump that assists the heart’s pumping function.
- ECMO
- A form of temporary support that can assist both the heart and lungs in critically ill patients.
- 83-year-old patient
- Had a recent heart attack, severe disease in the left main and all three major coronary arteries, and heart function of about 30%; he improved after Impella-supported angioplasty.
- 69-year-old patient
- Experienced a massive heart attack, cardiac arrest and profound circulatory collapse; he was eventually weaned from ECMO and discharged.
- Follow-up outcome
- The 69-year-old patient’s ejection fraction improved to 53%.
- Required expertise
- Use of advanced MCS requires interventional cardiologists, cardiac anaesthetists, intensivists, perfusion specialists, nurses and round-the-clock critical care.
- Availability in India
- Advanced MCS is currently available mainly in select tertiary-care centres, with access expected to expand as more centres develop the necessary expertise and infrastructure.
Quotes
Prof. Dr Babu Ezhumalai
Senior Consultant in Interventional Cardiology at MGM Healthcare, Chennai
“"When I got trained in interventional cardiology nearly two decades ago, many patients with severely impaired heart function or cardiogenic shock had very few treatment options because the procedural risk was simply too great."”
deccanchronicle.com
“"Cases like these demonstrate how modern support technologies are expanding treatment possibilities for patients who would previously have been considered inoperable or too high‑risk."”
deccanchronicle.com
Sources
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