Pump device may help heal heart, study says

The artificial heart pump first was a bridge to a heart transplant. Then it was deemed suitable for permanent implantation in some patients. Now, a small British study suggests that use of a left ventricular assist device (LVAD) while using medication to shrink swollen tissue may heal some failing hearts.

The findings by researchers from Harefield Hospital in Middlesex, England, were reported this week in the New England Journal of Medicine. The article was accompanied by an editorial from two LDS Hospital cardiologists, Dr. Dale G. Renlund and Dr. Abdallah G. Kfoury.

The study, though small, "demonstrates that if we can rest the heart while we do medical therapies, we may make the heart recover in some cases," said Renlund, medical director of LDS Hospital's heart-failure program.

But Renlund cautioned that the study was small and excluded a number of heart-failure patients, including any who had experienced a heart attack or coronary artery disease, those "horribly ill" when they received an LVAD and those who couldn't tolerate the medications. Those medications included typical heart-failure drugs and one called clenbuterol that's used to strengthen the heart but is not approved here.

It will take more studies and time to prove the therapies, he said. But Renlund has seen similar hopeful results in his own practice.

Among the 5 million Americans with heart failure, Les Bowley, 48, from Lake McPherson, Kan., seemed destined to be one of the 58,000 heart-failure patients who die each year. When he came to LDS Hospital for an LVAD, his heart barely functioned.

He'd been sent home with hospice services, he said, until a doctor familiar with the Utah program suggested he might gain another three or four years of life by coming here. "I had a 13- and 14-year-old, so I thought, great, just enough time to get them raised."

He got an LVAD in January, along with support from the typical heart-failure medicines, so his care was similar to that in the study. He didn't use clenbuterol. In October, surgeons removed his LVAD. He will always need medication and follow-up, but had someone told him he'd be able to walk a mile a day or climb seven flights of stairs, he'd never have believed it, he said. Instead of dying, he's getting ready to go back to work.

Of the initial 27 patients enrolled in the British study, 15 received the LVAD and medications. In 11 cases, the patients did well enough to have the LVAD removed after 320 days and the clenbuterol stopped. Benefit of clenbuterol, researchers wrote, was "less firmly established."