Titanium mesh may slow heart failure

Placing a special mesh bag around the heart may improve its function for patients who are in an advanced stage of heart failure.

The device, called the HeartNet Ventricular Support System, is being tested at 30 medical centers around the country, including Intermountain Medical Center in Murray.

The mesh bag is made of a "super-elastic" nickel titanium that supports and reinforces the sagging walls of the oversized, weakened heart. It's hoped that the phase 2 clinical trial will find that it slows or stops heart enlargement, possibly even reversing it some, and improves the heart's function.

More than 5 million Americans have heart failure, including one in 10 of those over 65. Heart failure kills more than 300,000 people each year. The HeartNet device is designed by Paracor Medical Inc. for patients with dilated cardiomyopathy, a disease marked by a weakened, enlarged heart that doesn't pump blood efficiently. That, in turn, negatively affects the lungs and liver. More than half of patients die within five years of being diagnosed.

The device "gives a gentle squeezing on the heart," according to Dr. John R. Doty, cardiothoracic surgeon at IMC and the center's co-principal investigator for the study. It's a flexible material, he said, that unlike most metals, gets a bit stiffer as it warms up inside the body, providing structural support for the heart and helping it squeeze blood out with more force.

Early studies indicate patients may feel better and be able to do more if they have the HeartNet device, which is to be paired with other therapies, including medications. The most recent clinical study showed some improvement in patients' ability to be active and in their use of oxygen, as well as in how they viewed their own quality of life.

The current multi-center trial will see if it, too, finds those benefits.

The device comes in several sizes, just like the patients and hearts it's meant to help. Echocardiography is used to determine which one to use. To deploy it, Doty said the surgeon makes a small incision on the left side of the chest, in front, then pierces a small hole in the pericardial sac surrounding the heart. The mesh is placed with a "neat little device that stretches it out, envelopes the ventricles, releases the net and then wraps it." It's not unlike putting a pillow in a pillowcase. It shrinks back to its smaller size to provide the support and gentle squeeze.