I thought this was interesting. I had not heard of it
before.
Bill
_____________________________
By RENEE C. LEE, Associated Press Writer DALLAS - After five
heart attacks and a stroke, Charles Neal's heart was so worn
out that he couldn't walk across a room without feeling
exhausted and short of breath.
Constant fatigue caused by congestive heart failure
eventually forced the 72-year-old business owner into early
retirement.
"I used to go to work everyday, go on trips, but that quit
two years ago, I couldn't stand up to it," said Neal, who
owns of an underground fuel tank storage company in
Arlington.
That all changed a few months ago when Neal underwent
surgical ventricular restoration to have his enlarged left
ventricle reshaped.
Using a new device called a Mannequin, doctors restored his
round-shaped ventricle to its original oval-shape, allowing
the heart to pump more efficiently.
The device - a plastic shaper - is a new approach to an old
procedure that's been around for more than 20 years. What's
different is that the shaper has now made ventricular
restoration a standardized procedure for treating congestive
heart failure.
"This is the only device to do this operation," said Dr.
John Conte, the director of heart and lung transplants at
John Hopkins University in Baltimore. "It allows a doctor
anywhere in the world to do it the same fashion."
More than 5 million Americans suffer from congestive heart
failure, and about 1,000 people die each day from the
condition, typically seen in older people.
The disease develops when the heart is not pumping they way
it should, causing the heart to work harder. This happens
when the heart has been damaged or weakened by either
clogged arteries, high blood pressure or a heart attack,
causing the left ventricle to become enlarged.
Patients usually experience a range of symptoms, including
shortness of breath, fatigue, persistent coughing or
wheezing, and increased or irregular heart beat.
Doctors often treat the problem with medicine. Heart
transplants also are an option but most heart patients are
too old and too sick to withstand the surgery. Also, only 20
percent of people on the waiting list ever receive a heart.
Ventricular restoration appears to be a better treatment
because it gets at the cause of their symptoms, can improve
quality of life and perhaps help patients to live longer,
doctors said.
During a two-hour surgery, the shaper is inserted into the
left ventricle and then the heart wall is stretched around
the device. Once the heart is molded to the right shape
and inflated to the right volume, the device is deflated
and removed. A patch is sewn onto the heart to maintain
the shape.
So far, more than 700 patients in the United States have had
the procedure since the FDA (news - web sites) approved it
two years ago. The procedure costs about $22,000 to $35,000
and is covered by Medicaid, Medicare and private insurance,
said Bert Davis, president and chief executive of Chase
Medical, a company based in suburban Dallas that
manufacturers the device.
The procedure was pioneered by doctors in Italy, where heart
transplants are not available. John Hopkins is the only
training institution in the United States, but many have
American doctors received training in Italy.
Dr. Paul Grayburn, Neal's cardiologist at Baylor University
Medical Center in Dallas, said his hospital has done the
procedure more than 25 times and with good results.
Neal, who had severely depressed heart function, is now
walking 25 minutes on a treadmill without feeling exhausted
and looks great, Grayburn said. "I think it also holds out
promise for other patients," he said.
Ventricular restoration was first introduced as a way to
treat ventricular aneurysms - a swelling of the heart. By
the 1980s, doctors began using the procedure to treat
congestive heart failure but "before the Mannequin, doctors
had to do it by eyeball," Davis said. That meant some
ventricles were made too small, too large or too spherical.
In 1999, Chase Medical began collaborating with Italian
doctors to develop a device to help them achieve more
precise and consistent results. The new device eliminates
surgical guesswork when recreating the heart's original
size, shape and muscle, Davis said.
Even though the surgery was risky for Neal because of his
age and severe heart condition, he said it has allowed him
to return to his once active lifestyle.
"The worst thing was I could die on the operating table, but
I had reached a point in my life that I was so miserable, I
would take any chance for quality of life," said Neal, a
divorcee with three grown children.
He had the surgery along with six heart bypasses on his
birthday, Nov. 6. It was the best present ever, he said.
"I can't tell you how great I feel," he said.