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Archive for February, 2010

World’s Smallest Heart Pump Provides Minimally Invasive Option for Cardiac Patients

Chad Kimpel said it with a smile.

 

“I died. Multiple times.”

 

The 41 year old father of three from Farragut, IA first came to The Nebraska Medical Center on July 1, 2009. That was the day of the heart attack.

 

“My heart stopped before they got me on the life flight chopper to get here,” Kimpel recalled. “They shocked me and brought me back, but the doctor said I died several more times on the flight here. They kept bringing me back.”

 

Once at the medical center, Kimpel was diagnosed with heart failure. Treatments had him in and out of the hospital several times in the following months. When he returned to the medical center in January, his heart was working at just a fraction of its potential and his remaining arteries blocked. Kimpel’s cardiologists decided to place a stent in his artery.

 

A new type of heart pump allowed doctors to place the stents while Kimpel’s damaged heart continued to work. Instead of preparing for major heart surgery, Kimpel’s doctors placed the Impella 2.5 in his heart inside a cardiac catheterization lab at The Nebraska Medical Center. He was sedated, but awake during the procedure.

 

“The Impella acts almost like an artificial heart,” explained Ed O’Leary, MD, cardiologist at The Nebraska Medical Center. “Without this machine, his blood pressure would drop to dangerously low levels and he might not make it through the procedure.”

 

Dr. O’Leary inserted the Impella pump through the femoral artery in Kimpel’s left leg. He then guided it through his body into his heart. Once in place, the straw-sized pump assisted Kimpel’s heart by pulling blood out of the left ventricle and into the aorta. By keeping his blood flowing, the cardiology team was able to keep Kimpel’s blood pressure stable while placing the stents in his artery. Once the stents were placed, the Impella pump was removed and Kimpel’s heart was pumping blood through a newly cleared artery.

 

“Dr. O’Leary told me it was as close as I could get to having a new artery,” Kimpel said.

 

The Impella is designed to help the heart for short periods of time.

 

“There are machines that do the work of the heart,” Dr. O’Leary said. “Those bypass machines are used during open heart surgery. During those surgeries, the heart is stopped and the bypass machine does the work of the heart. Bypass surgery would have been very risky for Chad. With as weak as his heart was, it might have been very difficult to get his heart re-started after surgery.”

 

Instead of a long and risky open heart surgery, Kimpel’s angioplasty took only two hours. The Impella carried part of his heart’s workload for much of that time.

 

After the procedure, Kimpel was all smiles.

 

“I feel great,” he said with a laugh. “The technology is amazing. They put this little turbocharger in my heart and I feel great!”

 

Kimpel will have close follow up care with his cardiology team at the medical center. A carefully designed diet and exercise plan awaits him back home in Iowa.

 

“I’ve always been in good shape and kind of a health food nut,” he said. “But I’ll have to be extra careful about salt, and about doing too much exercise.”

 

The Impella was approved by the FDA in June of 2008.

Dr. Ed O’Leary (right) places the Impella 2.5 into the left femoral artery
of angioplasty patient Chad Kimpel

Stroke Care Recognized Nationally for Second Year

For the second year in a row, The Nebraska Medical Center has received the American Stroke Association’s Get With The GuidelinesSM–Stroke Gold Performance Achievement Award. The award recognizes the medical center’s commitment and success in implementing a higher standard of stroke care by ensuring that stroke patients receive treatment for at least 24 months according to nationally accepted standards and recommendations.

 

The Nebraska Medical Center will be recognized by the American Stroke Association in an advertisement in the July 21 “America’s Best Hospitals” issue of US News & World Report.

 

“This accomplishment signifies that The Nebraska Medical Center has consistently committed to and successfully implemented accepted standards, or guidelines, to improve quality patient care,” said Pierre Fayad, M.D., Director of the Stroke Center at The Nebraska Medical Center and Reynolds Centennial Professor & Chairman of Neurological Sciences at UNMC. “Rapid assessment, treatment and intensive acute care is vital for stroke patients to help them gain back as much of their lives as possible and prevent complications.”

 

View video: watch?v=bSPJ5oJI6to&feature=player_embedded

 

To receive the Get With The Guidelines-Stroke Gold Performance Achievement Award, The Nebraska Medical Center demonstrated 85 percent adherence in the Get With The Guidelines–Stroke key measures for 24 or more consecutive months. These include aggressive use of medications like tPA, antithrombotics, anticoagulation therapy, DVT prophylaxis, cholesterol-reducing drugs, and smoking cessation.

 

Dr. Fayad adds that the Get With The Guidelines-Stroke program addresses the important element of time. “With a stroke, time lost is brain lost,” said Dr. Fayad. The Nebraska Medical Center has developed a comprehensive system for rapid diagnosis and treatment of stroke patients admitted through the emergency department or transferred from other hospitals. The medical center ensures the prompt availability and coordination of medical professionals, personnel and equipment 24 hours a day, seven days a week. Highlights of its expertise include: rapid brain and blood vessel imaging; neurologists, neurosurgeons, emergency physicians, radiologists and pharmacists available to conduct acute patient evaluations; and use of clot-busting medications and interventional clot removal techniques when appropriate.

 

“The American Stroke Association commends The Nebraska Medical Center for its success in implementing standards of care and protocols,” said Lee H. Schwamm, M.D., Chair of the national Get With the Guidelines Steering Committee and Vice-Chair of the Neurology department and director of acute stroke services at Massachusetts General Hospital in Boston. “The full implementation of acute care and secondary prevention recommendations and guidelines is a critical step in saving the lives and improving outcomes of stroke patients.”

 

Get With The Guidelines–Stroke uses the “teachable moment,” the time soon after a patient has had a stroke, when they are most likely to listen to and follow their healthcare professionals’ guidance. Studies demonstrate that patients who are taught how to manage their risk factors while still in the hospital reduce their risk of a second heart attack or stroke. Through Get With The Guidelines–Stroke, customized patient education materials are made available at the point of discharge, based on patients’ individual risk profiles. The take-away materials are written in an easy-to-understand format and are available in English and Spanish. In addition, the Get With The Guidelines Patient Management Tool* provides access to up-to-date cardiovascular and stroke science at the point of care.

 

According to the American Stroke Association, each year approximately 795,000 people suffer a stroke — 610,000 are first attacks and 185,000 are recurrent. Every 40 seconds, someone in the United States is suffering from a stroke. This deadly condition accounts for 1 out of every 18 deaths in the United States. The number of acute ischemic stroke patients eligible for treatment is expected to grow over the next decade due to increasing stroke incidence and a large aging population.

 

The stroke center at The Nebraska Medical Center has also achieved recognitions from other organizations. The Nebraska Medical Center was Nebraska’s first and continues to be Omaha’s only stroke center to receive the “Gold Seal of Approval” from the Joint Commission for its dedication to the prevention and management of stroke. Dr. Fayad was also named the National American Heart Association Physician of the Year in 2009. He serves as the chairman of the American Stroke Association Advisory Committee.

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