Kapil Lotun, MD, Director of the Cardiac Catheterization Lab at Banner-University Medical Center talks about the Tandemlife Cath.
Interview conducted by Ivanhoe Broadcast News in August 2018.
Tell us how the TandemLife cath works.
Dr. Lotun: TandemLife is a device, which is used to support patients who are in critical condition from their cardiac issues, or they’re not getting enough blood to the rest of the body, or to help with the function of the heart. It’s a pump that takes blood from the heart, from the body and pumps it back, oxygenates it and pumps it back in the body. It kind of takes the function of the heart back. It consists of a few things, a catheter in the vein, venous system, to take blood, which has no oxygen, and bring it to the pump, and the pump then pumps it to an oxygenator where it gets oxygen. Then there is a catheter, which connects to the artery which pumps blood to the rest of the body. That way it takes over the function of the heart so that you have blood with oxygen going to the brain, your organs and your tissues.
But it’s just for use during a procedure?
Dr. Lotun: It’s used during procedure but it’s also used for patients who have had cardiac arrest or patients whose hearts are not working well to support them through that. It’s been used not for just a procedure in the cath lab but also in procedures in the operating room by surgeons.
What is the advantage of the TandemLife over whatever you had before?
Dr. Lotun: The TandemLife, the pump is an older pump it’s been on the market, but with the oxygenator it makes it easier for us to really put these devices in the nick of time you know when patients are really sick and we can put it in the cath lab at a very rapid pace. It takes about five to ten minutes for us to put that device in.
Would it be something necessarily that you have all set up and in place before a surgery?
Dr. Lotun: It depends. If there are procedures which we’re going to do, if we know already that the patient is really sick and the time during the procedure they will require that extra support, when you are putting balloons and stents in the heart or doing any other kind of procedures sometimes the heart temporarily does not work as well. Therefore you plan ahead and you can put it in. But there are many situations where you don’t anticipate something going wrong and patients are just sick and they come in and you start doing something and they just crash. And therefore at that time it’s not prepared but we have it readily available in our cath lab that we can actually put it in very, very fast.
So who is this system for?
Dr. Lotun: It’s usually reserved for people who are really, really sick. People who have been in cardiac arrest, who have just survives a cardiac arrest. People who their heart is not working well and it’s not pumping enough blood. And or people whom their heart is really not doing well and you’re anticipating doing procedures on that heart and putting balloons and stents that they are candidates for. And that’s where our patient was a candidate for it.
As a surgeon what have you noticed before and after, what kind of improvement has it made on patient outcome?
Dr. Lotun: So as a cardiac interventionist I think the device allows us to take on much more challenging cases. In the past we would probably shy away from doing these things. Or even if we did it with the technology that was available to us, which is good technology, sometimes we did not get the optimum outcome in these people. Now it does allow us to treat more people effectively with a good outcome.
Is Ann Martin your patient?
Dr. Lotun: Correct. She was mine and my partner’s patient, we saw her in the hospital.
Tell me a little bit about her case?
Dr. Lotun: Her case is a very interesting case. She presented to an outside hospital where she was complaining of chest pain, she was short of breath, she was in congestive heart failure. At the outside hospital they did a cardiac cauterization and she had severe, severe blockages of two main arteries. The left vein coronary artery and the right coronary artery. Just where it comes out from the aorta, so just at the beginning of that tree which supplies blood to the heart. So after the cardiac cauterization they sent her to the surgeons to operate on her. But she’s an elderly lady, she was frail. And patients such as her do not do very well with surgery. So although the surgery will go well, the repair is very long, the rehabilitation is long and sometimes there are other factors with problems, other issues which happen after the surgery. So the surgeons declined and she also given her age did not want to go through that procedure. They put her on medicine thinking that medicine will help and it does help in these people but medical therapy is not the only thing you need to have in tandem with something more and she was discharged home. Over the weekend she was really sick, she saw one of our colleagues Dr. Joe Alfred in the clinic. And Dr. Alfred admitted her because she was really, really sick. So she was admitted to the intensive care unit that’s how sick she was and we went ahead and put a balloon pump which is another device to help her with the time, to decide during the time what to do. Our surgeons here also saw her and thought that she was a very high risk for surgery. That’s when we decided okay, we talked to her I said, we have this device we use it for the people with heart problems in other situations we have never used it in this situation. But it makes perfect sense for us to use it. So that’s how we did her case.
How did she do?
Dr. Lotun: She did very well. She actually went home I think two or three days after we were done. And she didn’t have much left, if she had not come I don’t think she would have made it all this time.
What else haven’t I asked you about this do you think we should include in the story?
Dr. Lotun: I’m not sure.
END OF INTERVIEW
This information is intended for additional research purposes only. It is not to be used as a prescription or advice from Ivanhoe Broadcast News, Inc. or any medical professional interviewed. Ivanhoe Broadcast News, Inc. assumes no responsibility for the depth or accuracy of physician statements. Procedures or medicines apply to different people and medical factors; always consult your physician on medical matters.
If you would like more information, please contact:
Jean Spinelli
520-626-2531
Sign up for a free weekly e-mail on Medical Breakthroughs called First to Know by clicking here.
