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First-in-the-World Device Helps the Right Side of the Heart – In-Depth Doctor’s Interview

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By on Cardiovascular Medical News

Cardiac surgeon at the Hackensack University Medical Center, Yuriy Dudiy, MD, FACC talks about Impella helping heal the right side of the heart.

Interview conducted by Ivanhoe Broadcast News in 2022.

We’re talking today about the newest generation of the impeller heart pump. When you have patients coming in with heart failure, what are their options, and who would be appropriate for this particular pump?

DUDIY: Patients for this device usually present with heart attack. Patients in heart attack can have heart failure. Up to 40 percent of patients have RV failure. Historically, we were focusing mostly on the left ventricle, but now we’re realizing that patients that have RV failure are not doing well. Devices that we have currently are requiring are more invasive. The benefit of RP flux is that this device or this device depletion remains mobile and can ambulate and can recover from the heart attack.

Doctor, you said historically you’ve been concerned about the left ventricle. Can you tell me why that is?

DUDIY: The left ventricle is the main chamber that pumps the blood to the rest of the body. The thought was that if you provide enough blood flow to the body, there’ll be enough. But just having not enough congestion.

You and your fellow cardiologists felt that by giving the left ventricle in good shape the patient would be supported?

DUDIY: In reality, we don’t know how to quantify the right ventricle failure that easily.

So, without treating the right ventricle, what kind of problems does that pose for a patient?

DUDIY: When you treat just the left ventricle, you must support the right ventricle. Until now, we’re using very high doses of medications and that on itself increases mortality.

Tell me a little bit about using a heart pump to assist patients. Impellea has primarily in the past been for the left ventricle.

DUDIY: We have several IBMAI devices impellers that are designed for left ventricular support. Now we have a short-term pump that can provide about 3.5 liters of flow and can be inserted from femoral artery. We also have impeller 55, which can provide up to six liters of flow. That was inserted surgically to the axillary artery. That device can stay for weeks, allowing enough time for the ventricle to recover.

Now the newest technology is for the right ventricle. Can you explain?

DUDIY: The impellea RP flux is designed to be inserted percutaneously, which means just with a needle stick. It goes into the heart and provides support to the right ventricle. It can bump up to four liters of blood, and can stay up to two weeks and that should be enough time to allow the heart to recover.

You had mentioned before there is a benefit to going through the neck. Can you explain?

DUDIY: The benefit going through the neck is the patient can sit upright or can ambulate in the intensive care unit while recovering. The problem that we see that patients who present with heart attack and they are immobilizing the bat, they’re not only not recovering well, but they’re also getting deconditioned and then it takes a lot of time to bring them back to their functional status.

Now you said this work can be implanted in a patient for up to two weeks. What is the thought at that point? What is the next step? Is it a bridge to something?

DUDIY: These devices can be used as a bridge to either recovery or durable mechanical support, which is a pump that is inserted directly into the heart or heart transplant.

Is this newly FDA approved? What are you finding? You’ve been implanted two now, how are your patients doing on this?

DUDIY: Here I can say we implanted two patients so far and they both did well. The heart function recovered, and they are successfully weaned.

Can you describe for our viewers what the procedure would be to get the pump in?

DUDIY: In order to get the pump in, we have a needle stuck into one of the veins in the neck. Then the pump goes into the heart and has a catheter that is attached to the pump and that catheter is attached to a mobile unit that you can walk with.

So, the catheter is coming from the neck and then attached to the power source that keeps it pumping?

DUDIY: Yes.

Is there anything I didn’t ask you that you would want people to know either about this new device that you must help patients or about heart failure? Does it keep patients from needing more invasive procedures right away? Instead of going right to ECMO, what is the benefit of having this option?

DUDIY: The benefit of RP flux that we can also avoid more invasive right ventricle support, which most of the time we were using ECMO or RBAT that require surgical intervention and leading to a higher risk procedure on very sick patients. Having this minimally invasive option provides quick support to the patient that is very sick.

Is it small? How big is the device?

DUDIY: It’s about 20 centimeters in length and the catheter itself is about three millimeter in size.

What would that be comparable to? How big is 20 centimeters, is it grapefruit size?

DUDIY: No. It’s like a little pen.

And to patients, do you have plans to do more? How often will you be able to use this technology?

DUDIY: It’s underappreciated in general. We’re trying to identify those patients. The problem is that most of the patients are not scheduled. It’s all acute patients that we don’t know how many patients we’ll have. It might be two tomorrow and then nothing for a month. That’s how we got trained the day before. As soon as we got trained, we had a sick patient that needed it, and we had another technology to save that patient. At least at that point, we were ready to have this.

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:

Mary McGeever

Mary.mcgeever@hmhn.org

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