Heart Central

When a “top 5” hospital and leading heart-assist
By: 
Ryan Hiett

 

November 16, 2006

If its cancer care, emergency medicine, pediatric and maternal-fetal medicine specialties keep Robert Wood Johnson University Hospital (RWJUH) in New Brunswick at the forefront of nationally recognized hospitals, its heart center is what keeps it pumping.

The Heart Center of New Jersey, a 225-bed hospital-within-a-hospital, has excelled in providing primary angioplasty to heart attack patients, according to the U.S. Department of Health and Human Services’ Hospital Compare Web site, and was ranked in the state’s top five hospitals for heart attack care by the New Jersey Department of Health and Senior Services.

The center includes one of the busiest cardiac cath labs in the region. The Dr. Norman Reitman Cardiac Catheterization Laboratories is made up of seven labs, including two for cardiac electrophysiology. The suite handles more than 12,000 procedures each year.

In addition to diagnostic cath and coronary interventional procedures, cardiologists there are also performing peripheral vascular interventions in the labs.

The center houses RWJUH's Advanced Heart Failure and Transplant Cardiology Program, which offers heart treatments that include specialized medical, device and surgical therapy. The program offers care for patients with end-stage heart failure and has shorter waiting times for heart transplantation than most large metropolitan areas.

And now that its cardiac program has made it an Abiomed Inc. (Danvers, MA) “Center of Excellence,” RWJUH’s heart center is getting stronger every day.

A “Truly Rewarding” VAD

The “Center of Excellence” designation means the hospital is helping set standards for physician training on Abiomed’s ventricular assist devices (VADs), which provide temporary circulatory support for patients in acute heart failure. They also share best practices related to VAD implantation and patient care.

RWJUH’s chief of cardiac surgery Mark Anderson, M.D., led a national study on the use of Abiomed’s VADs titled “Mechanical Circulatory Support Improves Recovery Outcomes in Profound Cardiogenic Shock Post Acute Myocardial Infarction.”

The study found patients who suffered a heart attack followed by cardiogenic shock could recover the natural function of their heart when given Abiomed’s AB5000 circulatory support for an average of 31 days.

Of the patients who were able to survive the traumatic coronary event, 67 percent were able to recover. Dr. Anderson calls the results “truly rewarding.”

“I have found that by utilizing the AB5000, we are able to recover our patients’ hearts and send them home without a transplant, which can be costly and expose these patients to a variety of other problems,” he said.

By providing circulatory support, Dr. Anderson says an injured heart has time to rest. “If given enough time to rest, the cells of the heart can repair themselves,” he said.

And now the center is one of the few hospitals in the country with a fully implantable artificial heart coming its way — RWJUH was chosen in September to offer Abiomed’s newly FDA-approved AbioCor.

Dr. Anderson says 20,000 to 30,000 patients a year could benefit from the technology, according to an article from USA Today.

“There are a million acute heart attacks a year in this country,” he said. “About 70,000 are complicated by shock, and from 30 to 50 percent don’t respond to conventional therapy.”

A two-year study led by Dr. Anderson and financed by Abiomed tracked every patient who received treatment from the device to give their hearts a break after massive heart attacks. The 50-patient study was the first evidence that the device saves lives.

“We’ve basically doubled survival,” Dr. Anderson said. “Not only was survival improved, but nearly 70 percent recovered their native cardiac function. It’s one thing to have a patient survive and go home in heart failure. It’s another to go home with good heart function. The pumps minimize injury to the heart.”

Transmyocardial Revascularization

The center is also one of a few hospitals in the world that offer a new laser procedure to treat inoperable coronary artery disease (CAD).

During transmyocardial revascularization (TMR), a surgeon makes an incision on the left breast to expose the heart. Using a laser, the surgeon drills a series of holes from outside of the heart into the heart’s pumping chamber. From 20 to 40mm laser channels are placed during the procedure.

Bleeding from the laser channels on the outside of the heart stops after a few minutes of pressure from the surgeon’s finger.

In some patients TMR is combined with bypass surgery. In those cases, an incision through the breastbone is used.

  • The AB5000 Circulatory Support Device from Abiomed Inc.