Debbie Ettleman is one of the first patients at St. Vincent Healthcare to receive a full-support heart pump that just a month ago would have required her to fly to a major city.
When patients’ hearts are weak, surgeons attach the device to replace function of the left side of the heart – allowing those muscles to completely rest, said Dr. Simon Maltais, a cardiac surgeon recently hired at SCL Health.
Maltais attached the pump prior to Ettleman’s quadruple bypass operation. The surgeon and nurse practitioners could then control blood flow with a dial at her bedside during recovery.
Dr. Maltais, with SCL Health, discusses a new heart pump implant operation now offered at St. Vincent's
“We did the bypasses, and knowing that her heart would have a hard time coming off the lung machine, we used the device to support her for the first few days after surgery to let the heart kind of respond, settle, and gradually get better away from the trauma of the intervention,” Maltais said.
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Ettleman, a Billings resident, was unwell for the few months before her surgery in early January. “I was worried it might be a heart issue but I kept waiting until after the first of the year. Christmas came and I just couldn’t breathe anymore,” she said.
A body starts retaining fluid when the heart is in trouble, and Ettleman was almost 20 pounds heavier with swollen feet, legs, and swelling beginning in her face.
“But the fluid doesn’t all go into the arteries and the heart,” Maltais said. “It goes everywhere. So it goes into the lungs and she was very short on breath.”
The device pushes blood from the left side of the heart and across the aortic valve to the rest of the body.
The device itself costs around $30,000 to $35,000, but when patients can undergo surgery in Billings, the procedure is more likely to be covered by insurance because it could be in-network.
Until now, locals who were unable to travel to another city had to settle for the use of older pump models that afford less assistance to the heart. Medications can substitute for increased blood flow but it is not always healthy, Maltais said.
“The drugs are good to support the heart but they also have effects on kidneys, liver, and other things, so when we hit a level of support we feel is too high – and we have levels of criteria, then we use that pump,” he said.
The Impella 5.5 pump recently saved the life of a patient, said Dr. David Sims, a cardiac surgeon and colleague of Maltais.
“This kind of changed everything,” Sims said. “He was struggling and his blood pressure was struggling, and all of the sudden [the blood pressure] normalized because the machine does the work for the heart and it rests the heart.”
Cardiac surgeons David Sims and Simon Maltais talk about a new heart pump in use at SLC Health.
Ettleman spent days in the Intensive Care Unit. Fast-forward three weeks, and she is rehabbing at the hospital three days a week. She still feels weak but is improving daily, she said.
“We really work closely altogether with cardiology and ICU, and we really rebuilt or revamped the way we were treating patients,” Maltais said.
This all aligns with the hospital’s initiative to boost heart care operations for people in Billings and surrounding areas, said Mike Paquette, communications manager for the hospital.
St. Vincent is also offering less invasive heart surgeries with the use of robots among other initiatives, Maltais said.
“This is a fantastic tool to have, and it’s exciting to see where we’re going to go with this device,” said Joy Rodriguez, a nurse practitioner who works in SCL’s health heart and vascular institute alongside the surgeons.
