Heart pump made here brings hope to cardiac patients

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Two years ago, Gurcharan Gill's heart was so weak he could hardly lift a newspaper, much less walk up a flight of stairs or get up out of a chair.

On Thursday, the 76-year-old Morgantown, W.Va., resident spent most of the morning in his two-acre garden, working and weeding -- powered by the same kind of small heart pump implanted last week in the chest of former Vice President Dick Cheney.

Since its approval by the Food and Drug Administration 18 months ago, the little pump is earning a big reputation, surprising cardiologists and giving new hope to patients who either need to buy time waiting for a transplant or for those who aren't good candidates for a new heart but need help.

There's a Pittsburgh connection, too.

Local researchers and engineers at UPMC's McGowan Institute for Regenerative Medicine had a major role between 1995 and 2000 in designing the pump, known as the LVAD, or left ventricular assist device, said Robert Kormos, director of UPMC's artificial heart program.

Once the device design was completed, UPMC and Allegheny General Hospital were among some 30 health centers participating in clinical trials.

"I thought it might be an incremental improvement in the treatment of congestive heart failure," said Stephen Bailey, director of cardiac surgery at AGH.

"But we've been more and more impressed the longer we've gone on using it, with the results dramatically better than we thought they'd be. I have to say it has exceeded my expectations."

Patients with congestive heart failure who receive the device are either waiting for a transplant or are not candidates for a transplant for certain health reasons such as diabetes or obesity.

Today, nearly 3,000 people are using the LVAD, according to a government registry that tracks patients who receive the devices -- up from 700 people two years ago, a "remarkable" increase, he said.

While a heart transplant is still the best treatment out there, 75 percent of those who have received an LVAD are still alive after three years -- a survival rate approaching those who received new hearts, Dr. Kormos said.

"We're not talking about these pumps replacing the need for a heart transplant, but they keep alive those people who would be dying before getting a transplant, or who can't have one," he said.

As for the 69-year-old Mr. Cheney, who has battled heart problems most of his adult life -- his first heart attack was at age 37 and he's had four since -- the pump will allow him to resume normal activities.

It's not clear if Mr. Cheney, who hasn't made public details of his treatment, has been listed for a heart transplant.

About a half dozen centers worked on the early design for the rotary heart pump, which received $26 million in federal funding, Dr. Kormos said, including UPMC, and once the design was completed, both UPMC and AGH participated in clinical trials of the device, called the HeartMate II, marketed by Thoratec.

James Antaki, a Carnegie Mellon University biomedical engineer who also holds an adjunct professorship at Pitt, developed the algorithms used in the computer software that controls the pump -- alongside another engineer who used to design jet engines.

The key, Dr. Kormos said, was to design an internal propeller, or "impeller," that would pump just the right amount of blood at the right rate through the heart. Engineers spent countless hours on computers refining the blades on a shaft that looks very much like a corkscrew, he said, so that they had correctly engineered angles and heights.

"In the case of jet engines, you're trying to design a rotor that produces the least amount of friction to the air so it doesn't generate undue drag," Dr. Kormos said. "The same is true with moving blood. You don't want a Waring blender in there, you want something that won't damage blood cells and is compatible with blood."

The pump is much smaller than a previous version and less prone to wear and tear, added AGH's Dr. Bailey.

Just a few weeks ago, Mr. Cheney said he was entering "a new phase of the disease when I began to experience increasing congestive heart failure," and as of Thursday was still recuperating at Inova Fairfax Heart and Vascular Institute in Washington's Northern Virginia suburbs, where he'd had the operation.

For Mr. Gill of Morgantown, whose heart weakened after he underwent chemotherapy in 2003 for lymphoma, life has changed dramatically -- he's making plans to travel to his homeland, India, later this summer.

"I feel like a new man," he said.

And for Dr. Kormos, the LVAD "gives a certain sense of hope for people who are running out of options. Instead of internists telling patients 'There's nothing we can do for you,' they'll be able to say, 'Well, you know, there is something.' "

Mackenzie Carpenter: mcarpenter@post-gazette.com or 412-263-1949.


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