Indiana University Health says one of its surgical teams is the first in Indiana to use a new technique during a heart pump implant procedure. The system says the method allows surgeons to place the device with only a small incision.

September 3, 2014

News Release

Indianapolis, Ind. — A surgical team at Indiana University Health Methodist Hospital recently became the first in Indiana and one of the few in the nation to use a new, minimally invasive technique to implant a ventricular assist device—a miniature, mechanical implant designed to help a failing heart pump blood from the organ’s lower chambers to the rest of the body.

This medical first for Indiana was performed by a team led by Indiana University Health cardiothoracic surgeon Dr. Z. A. Hashmi to benefit Kevin Pulley, a 56-year-old husband and father of six from the Fort Wayne, Indiana area. Pulley suffered from a rapid onset of viral cardiomyopathy. When medications failed to help, his doctors recommended that he get a ventricular assist device.

A ventricular assist device can serve as either a 'destination therapy'—where a patient lives with the mechanical implant for the rest of their lives—or as a 'bridge to transplant' that supports a patient's weakened heart until a new organ becomes available. As technology has advanced over the years, these mechanical devices have been made smaller and more compact, making it possible for doctors to use less invasive surgical approaches when implanting them.

The traditional way of implanting a ventricular assist device involves a major operation where surgeons open the patient's entire chest and break the sternum in order to connect the mechanical device to the patient's failing heart. This invasive, open chest approach required the use of a heart-lung bypass machine and often caused scar tissue that could prolong and complicate future heart transplant operations to remove and replace the damaged heart.

Now, surgeons are using a new and far less invasive approach that enables them to implant such devices without breaking a single bone. Instead of opening the patient’s ribcage through the breastbone, surgeons make a small incision on the side of the chest so they can tuck the compact mechanical implant under the patient's ribs and place it directly on the heart. Surgeons at IU Health Methodist Hospital were also able to perform this minimally invasive technique without the need of a heart-lung bypass machine.

Patients who have their ventricular assist devices implanted using this new, minimally invasive approach can benefit from smaller incisions, a shorter surgery and hospital stay, a faster recovery and a lower risk of complications.

The new technique also helps surgeons to plan and improve outcomes for a patient's future transplant surgery.

“Using this new approach, the patient's chest remains ‘untouched territory,’ which greatly benefits them during their initial operation and recovery and facilitates a faster, safer future heart transplant operation,” said Dr. Hashmi, who specializes in heart and lung transplantation and ventricular assist devices.

“It's amazing what doctors are able to do now. I would have died if it wasn't for this surgery. And now I feel great,” said Pulley, who became so weak before his operation that he couldn't brush his teeth without getting fatigued. “This entire experience has really helped me to slow down and appreciate the little things in life.”

IU Health Methodist Hospital is among a handful of centers in the United States that have adopted this minimally invasive approach. Duke University Medical Center and the University of Maryland Medical Center are some of the other hospitals using this new technique.

“Heart failure is a growing concern in the medical field,” said Dr. Hashmi, who also recently implanted a ventricular assist device without using a heart-lung bypass machine which benefited another patient who is believed to be one of the first in the nation to be extubated in the operating room immediately following their surgery. “If we keep doing things the way we've always done them, then our results will remain the same. It is important that we continue to innovate and keep pace with advancing medical technology as we develop safer operating techniques for patients.”

The IU Health Cardiovascular Center at IU Health Methodist Hospital, one of the largest ventricular assist device centers in Indiana, offers the latest cardiovascular support technology approved for medical use. As a nationally recognized, high-volume cardiovascular program connected to Indiana University School of Medicine and the IU Health Methodist Research Institute, IU Health participates in national trials of newer device technologies so patients can benefit from the latest and leading edge treatments.

Source: Indiana University Health

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