Tribune/Debra Reid - A tiny pump, inserted through a blood vessel to his heart by interventional cardiologist Dr. Devang Desai, helped save the life of heart attack victim Edward Gilbert. The pump moved blood through Gilbert's heart during emergency coronary surgery by Dr. Desai at Renown Medical Center.
Tribune/Debra Reid - A tiny impellor inside the Abiomed Impella 2.5 heart pump helps draw blood through the heart and into the body during cardiac surgery.
Gilbert, 64, is the first patient in northern Nevada to undergo a procedure in which a tiny pump was placed directly into his heart to allow surgeons to open blocked arteries during a heart attack.
“The device, known as the Impella 2.5, is the world’s smallest heart pump,” a press release from Renown states. “Nearly 1/100th the size of the heart, it is so small that rather than sitting outside the body as traditional heart pumps do, it is inserted directly into the heart through an artery in the leg.”
Dr. Devang Desai, who performed the procedure and was instrumental in bringing the Impella 2.5 to Reno, said Gilbert arrived at the hospital with “significant blockage” in his left main artery.
“That usually translates to open-heart surgery,” said Desai, interventional cardiologist with Sierra Nevada Cardiology Associates and medical director for the Chest Pain Center at Renown.
“Gilbert had a history of coronary artery disease that was being controlled with medication,” the release states. “During the week of Oct. 11, he was having chest pains even at rest and blood tests revealed he was having a heart attack.”
“The medicines were no longer working and Mr. Gilbert’s options were limited,” Desai said.
“He was admitted to the hospital and physicians were forced to weigh the risks and benefits of treatment options,” the release states. “The heart surgeons deemed it too risky to do an open-heart surgery to bypass the blocked heart arteries.”
Desai said Dr. Kevin Linkus, a cardiac surgeon, told Gilbert he had more than a 50 percent chance of dying if an open-heart bypass surgery was performed.
“Option one was to do nothing, which really wasn’t an option,” Desai said. “Option two was a high-risk open-heart surgery, and option three was balloons and stints.”
The third option also would be risky, Desai said, and would involve using the Impella as an alternative to the traditional method of opening Gilbert’s chest.
Desai said Gilbert was too sick to attempt opening his chest, and while the Impella is not the best choice for every patient, it seemed the most viable option for Gilbert.
Fortunately for Gilbert, Renown purchased the Impella just two weeks prior to his admission to the hospital.
“I had already trained on it,” Desai said, but it had not yet been used on a patient.
Desai had a long discussion with Gilbert and his fiancé, Marcia Fields, and they decided to try the Impella.
“We went forward with an Impella-assisted high-risk percutaneous coronary intervention,” Desai said.
According to MedicineNet, “Percutaneous coronary intervention is accomplished with a small balloon catheter inserted into an artery in the groin or arm, and advanced to the narrowing in the coronary artery. The balloon is then inflated to enlarge the narrowing in the artery.”
“Desai and his team were able to successfully perform high-risk coronary stenting and Gilbert was on his feet walking in four hours after the procedure without chest pain,” the release states.
Recovery time for a patient who undergoes open-heart surgery is five to seven days, Desai said.
“Open-heart surgery is definitively more invasive,” Desai said.
Gilbert said he wasn’t nervous going into the surgery, and Fields said the Impella gave them hope.
“Not much makes me nervous,” Gilbert said. “When I go home, I’m gonna slide in on my butt. I’m not afraid of anything.”
Fields said she has been with Gilbert through previous minor surgeries, and the Impella-assisted surgery was “easier than the others.”
“This is how lucky we are,” Fields said. “If he had the angioplasty two weeks before he did, he wouldn’t be here.”
“I am very happy that Renown was here and had this device,” Gilbert said. “Overall I am very happy.”
Gilbert was willing to be first to have the procedure with the new technology so others may benefit in the future, Fields said.
“Ed was more than happy to do this so it can save the lives of others,” a tearful Fields said. “We want to let them know that this technology is out there because it saved his life.”
“The good Lord works in mysterious ways,” Gilbert said.

