Portable heart assist pump working fine
This story ran in the Houston Post on Oct. 2, 1991. The words and the headline are reprinted as they appeared then.
For the last month, 33-year-old Mike Templeton of Humble has been kept alive by a portable, battery-powered heart assist pump.
So far he feels fine.
The reason Templeton was the center of attention Tuesday at the Texas Heart Institute is that he is only the second recipient of the portable pump and is the first one who appears to have regained anything close to normal mobility.
The first patient to use the portable heart assist device was 52-year-old Larry Heinsohn of Shreveport, La. Heinsohn was implanted with the device on May 9 and died two weeks later without showing significant improvement.
Templeton is up and walking, a far cry from his condition before he received the pump Sept. 3. Before the pump, Templeton was 40 pounds under his usual weight, had trouble breathing and could barely get out of bed.
“I couldn’t breathe, I couldn’t work, I couldn’t do anything. I couldn’t even take care of my kids,” Templeton said. Now it’s different.
“I feel fine,” Templeton said as he managed a smile.
The portable battery pack is the main difference between Templeton’s situation and that of the others who have used a heart assist pump to help them survive until a donor heart was available for transplant. The battery is held in a shoulder holster.
The left ventricular assist pump is surgically inserted into the patient’s abdomen and is attached to the cardiovascular system, leaving the natural heart in place. Previous models of the device required that the patient be connected to the pump’s pneumatic power source, an external console on wheels.
The pump itself, called HeartMate and produced by Thermo CardioSystems Inc., has been used in 12 patients who later received heart transplants at Texas Heart Institute. The federal Food and Drug Administration has authorized the institute to install five portable pumps this year. After those tests the device will be tried at other hospitals.
The eventual goal is to develop an implantable, portable heart assist device that patients could wear on a long-term basis.
Estimates are that anywhere from 30,000 to 50,000 patients each year could be saved by such a device. “Right now they’re dying, except for the ones who get transplants and that’s only about 2,000,” said Victor Poirier, president of Thermo CardioSystems Inc.
He said the average duration of support with the HeartMate is three months.
“The bridges are getting longer and longer,” Poirier said.
Bud Frazier, director of heart institute’s transplant program, said Templeton’s size, (he once weighed close to 220 pounds) may make it difficult to find him a donor heart. The last patient fitting Templeton’s dimensions and blood type had to wait six months for a heart.
Patients using the new portable power pack will still be required to remain in the hospital until they receive a transplant. Eventually the hope is they will be able to return home.
Some of the advantages of the heart assist pump include that its use does not require the removal of the natural heart, no anti-rejection measures are needed and, since the left ventricle performs about 80 percent of the heart’s work, an assist pump is sometimes all that is needed.
The Food and Drug Administration has guidelines about which patients can use the pump. Frazier said proper patient selection goes beyond looking at blood pressure and cardiac function.
“Medicine is still an art, a quasi-science. We can use numbers but in the last analysis we rely on judgment,” Frazier said. “It’s ‘This patient is about to die if we don’t do something about it right now.’ ”
Templeton would become the longest surviving recipient of an experimental battery-powered heart assistance pump at the time, a poster child for the technology’s promise. But while he felt great physically, it wasn’t all smooth sailing.
Under the FDA’s requirements for the trial, any patient receiving the HeartMate device had to stay in the hospital until a donor heart could be found, the best possible place should an emergency develop. The requirement wreaked havoc on Templeton’s psyche.
“I’m a prisoner,” Templeton complained in an April 1992 Chronicle article. “I want out.”
In September, Templeton got his wish when the FDA gave approval for patients with the pump to leave the hospital while awaiting a transplant. Elated, he returned home for stints at a time. No suitable heart ever materialized, but Templeton thrived nevertheless.
In January 1993, 505 days after the implantation, Templeton died of a stroke, a national story. Doctors determined the death was not related to the device.
Two years later, nearly 30 after Dr. Michael DeBakey implanted the first left ventricular assist device at Methodist Hospital, the HeartMate became the first such device approved as a bridge to transplant. Templeton was the first patient to show LVADs could work not just as a bridge but for the long haul, known as destination therapy. In 2003, the FDA approved the first LVAD for such long-term therapy.
Today, such use is the norm. The implantation of LVADs as destination therapy now exceeds those as bridge therapy.
- Todd Ackerman