New heart procedure makes U.S. debut in Nebraska

People with diseased hearts live longer these days, but that’s increasing the number of damaged hearts that eventually grow big, floppy and ineffective, a condition called heart failure.

A procedure that made its U.S. debut at the Nebraska Heart Hospital on Friday could grow into a common treatment for heart failure patients who fail typical first-line treatments.

The procedure involves a special tool for placing a polyester sock around the expanding heart, a big advance over placing the sock by hand, said Dr. James Wudel of the Nebraska Heart Institute, who said the device could become as common as pacemakers.

A little background: Each beat of a big heart moves just a fraction of the blood moved by smaller, springy hearts, said Dr. Deepak Gangahar of the Nebraska Heart Institute.

So far, Wudel and Gangahar have each placed one heart sock using the device.

Medicine is the first treatment for heart failure; pacemakers the second.

The next step typically would be a heart transplant, but while as many as 70,000 people could benefit from one each year, just 2,200 donor hearts are available.

Alternatives include mechanical pumps to assist weak hearts or surgery to reshape them. Research is being done on using stem cells to repair damaged tissue.

And then there’s the sock.

It works by supporting normal heart pumping while restricting further heart expansion.

When Gangahar began working with the sock several years ago, surgeons made a 10-inch incision and split open the chest. Then they placed the patient on a heart-lung machine. whois Hospital stays and recovery were long and painful.

In most cases, Gangahar said, the sock did restrict further heart growth, and pumping was improved for a third of patients.

But Wudel said patients weighed the pain, risk and potential rewards, and often decided it wasn’t for them.

The new Acorn GEN2 Cardiac Support Device eliminates the need to split the chest and put the patient on a heart-lung machine.

Metal fingers push the polyester sock through a 3-inch incision under the left breast and between the ribs. The device has a small suction cup that grabs the bottom of the heart and holds it in place while the fingers put the sock around the sides.

The heart has a natural groove about two-thirds up, where the smaller and larger chambers fuse, and an elastic band on the sock fits into it.

“This is technology that really benefits the patient,” Wudel said.

The recent procedures took 90 minutes, with 12 minutes spent placing the sock, he said.

Fewer than 10 similar procedures had been done in Europe before Nebraska Heart Hospital did its two. In Lincoln, doctors did the procedure in a cath lab instead of an operating suite, taking advantage of the lab’s superior imaging technology, Wudel said.

“It’s an investigation,” Gangahar said. “It’s not proven. Only time will tell which way the results shake out.”

Reach Mark Andersen at 473-7238 or mandersen@journalstar.com.

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