Sam Lister, Health Editor
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A miniature “egg whisk” that rotates faster than a high-speed food blender has been pioneered by a British doctor to help the heart to pump blood round the body during life-saving surgery.
The ground-breaking procedure, which involves passing the fold-up whisk through the body to a site next to the heart, allows patients with weak hearts to have an artery unblocked without the risk of kidney failure or cardiac arrest.
More than 100,000 patients undergo artery-clearing angioplasty annually, but many remain at high risk of serious complications because of their problems pumping blood.
But now Professor Martin Rothman, a cardiologist based at the London Chest Hospital, has completed the first human trials of the revolutionary whisk, which is inserted via a catheter through the groin shortly before the angioplasty takes place.
The procedure, which has not yet been licensed, has proved so successful in patients to date that it was broadcast live yesterday to a key conference in San Francisco attended by 10,000 cardiologists. The whisk, called the Reitan catheter pump, is inserted in a tube via the femoral artery and manoeuvred up to the aorta, where it folds out to form a plastic cage encasing two stainless steel propeller blades of about 8mm in length.
Once switched on — a wire running down the catheter allows it to be powered electrically — the device rotates at up to 12,000rpm, enhancing the pumping action of the heart by drawing blood down from the aorta to the arteries. This keeps vital organs, such as the kidneys, working as the patient undergoes angioplasty.
Professor Rothman told The Times that the device effectively “unloaded the heart”, reducing the risk of heart attack, kidney failure and cardiogenic shock — when reduced blood flow causes multi-organ malfunction. Once the angioplasty is completed, the Reitan catheter pump can be removed.
Professor Rothman said that with up to one in ten patients who need angioplasty being at risk of cardiac and renal failure, the device would bring benefits for thousands of patients every year and even appeared to improve severe kidney problems. He added: “This technology offers real opportunity for sick patients to undergo a very important procedure — patients who, were you to blow a balloon up in their arteries, would otherwise likely be pushed over the edge.
“The pump is incredibly powerful — if you stuck it in a bucket of water it looks like the whole thing is boiling. It helps people with heart failure survive this procedure better and with less risk.”
Professor Rothman carried out the first trial after discovering the device, designed by Øyvind Reitan, a Swedish cardiologist and engineer, a few years ago. To date, the British doctor, who works in Barts and the London NHS Trust, has carried out 17 procedures, with published data on the first ten. While a pump would cost about £1,000, and can be used for only one procedure, the savings of preventing a patient from ending up on kidney dialysis are substantial. Three days on dialysis would cost about £10,000.
For the surgery last night, Professor Rothman operated on a woman, 79, who had blockages in her right coronary artery and proximal left anterior descending artery. As a diabetic with high blood pressure and raised cholesterol, the woman had been refused angioplasty by other cardiologists. She is now back on the ward.
Describing the notion that it might reverse kidney failure as a “Star Trek moment”, Professor Rothman said that his team were examining evidence collated so far. One case involved a woman who was only able to pass 10ml or urine per hour in the two weeks before the operation because of poor kidney function, who passed ten times the amount with the device in place.
“It was a revelation to see that patients who had a chronic or long-term impairment of the kidney could actually have that state reversed using the pump,” he said. “That was amazing. We saw the data and it made a lot of us think again. You think most people who have chronic kidney failure have exactly that. You don’t expect them to impove their function and that’s what we have seen.”
Ellen Mason, a cardiac nurse with the British Heart Foundation, described the work as pioneering.She said: “It is great to see a British cardiologist leading the way in the field of international cardiology.
“The application would be in people with cardiogenic shock which is usually fatal, or severe heart failure probably due to a heart attack. The hope is that they would be able to undergo urgent treatment for heart attack, when before it would have been too risky.
“The data from these trials will determine whether this will become more widespread in the UK and the rest of the world.”
A representative for Barts and The London NHS Trust, which includes the London Chest Hospital, said that it fully supported Professor Rothman’s work. “The trust is committed to providing first class clinical care to all its patients. Our support of cutting-edge research work such as the Reitan Catheter Pump System, is just one example of our ongoing work to help patients to live better, fuller and longer lives.”
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