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Small but mighty

Toronto, February 23, 2016

By Geoff Koehler

Dr. Christopher Buller holds an Impella heart pump
Dr. Christopher Buller, an interventional cardiologist with St. Michael’s Hospital, holds an Impella heart pump — used to partially or fully take over the work of pumping blood in a patient’s heart. (Photo by Yuri Markarov)

It’s the width of a pipe cleaner and has a motor shorter than a pen cap.

With its diminutive proportions, the Impella is the world’s smallest heart pump—a minimally invasive, temporary life-support device.

“The miniature motor is a Jet Ski engine that can turn at several thousand r.p.m.to pump blood between ailing chambers of the heart—from the ventricle to the atrium—and then throughout the body,” said Dr. Christopher Buller, director of Cardiac Catheterization and Intervention for St. Michael’s Hospital.

Ventricular assist devices, such as the Impella, partially or completely replace a failing heart’s function of pumping blood through the heart and into the body. The Impella can do the work for patients whose failing hearts are too weak for open-heart surgery. It also allows the clinical team to put the heart at rest during other complicated procedures.

“During a complicated angioplasty, we can use this mini pump to give the heart a break and do things that would not otherwise be survivable—such as blocking flow of a large blood vessel,” said Dr. Buller. “We can work more carefully, slowly and deliberately and maintain blood flow to the vital organs while the heart takes a breather.”

   
In the case of patients who need a heart transplant, the Impella can be a key tool to get the patients healthy enough to be safely transported to Toronto’s heart transplant centre at UHN.

The Impella can be used for a few hours but not longer than a week or two. Larger, battery-powered mechanical hearts, such as an LVAD (left ventricular assist device), can be used for several years to alleviate the heart’s workload—but installation of LVADs requires open-heart surgery and can take hours.

“We can install an Impella in 10 minutes,” said Dr. Buller. “From there, we can work more easily to stabilize the patient and get them healthy enough to recover on their own or stable enough for a long-term solution such as an LVAD or a heart transplant.”

The diminutive devices have been deployed five times at St. Michael’s since June. Dr. Buller is funded to use Impellas for 10 cases in 2015-16.

About St. Michael's Hospital

St. Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in 27 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, care of the homeless and global health are among the hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Centre, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael's Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.