Fresno Bee columnist Traci Arbios owes a lot to the “world’s smallest heart pump” – and the doctors who placed it in her body.
The motor, smaller than a Tylenol capsule, kept Arbios, 46, alive for almost two days in November.
On Wednesday, the Fresno woman got a chance to see the Impella device that did the work for her heart.
“That’s it? It’s so tiny. That’s amazing,” Arbios said from inside a mobile learning lab that had been set up in a recreational vehicle parked near Saint Agnes Cancer Center in north Fresno.
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The heart pump, attached to a thin, flexible tube, is inserted in an artery through a tiny hole in the groin. It’s threaded into the left ventricle, the main pumping chamber of the heart, where it pumps blood into the ascending aorta, the main blood vessel from the heart.
That’s it? It’s so tiny. That’s amazing.
Traci Arbios of the tiny pump that was implanted in her heart
The device, which can pump 2.5 liters of blood per minute, allows the heart to rest. It can be used during heart procedures, such as the repair of clogged arteries, and to maintain blood flow and pressure during a procedure.
In 2015, the federal Food and Drug Administration approved the Impella 2.5 for high-risk heart procedures, said Daniel Ochoa, a company clinical consultant. The heart pump, manufactured by Abiomed, is meant to be used for a few hours but can be used for longer, he said.
Besides Saint Agnes, Ochoa said, the device is available at Community Regional Medical Center and Clovis Community Medical Center. It soon will be at Fresno Heart & Surgical Hospital and Kaweah Delta Medical Center in Visalia, he said.
Arbios, who is on medical leave, has no memory of being wheeled into the Saint Agnes Medical Center cardiac catheterization lab where Dr. Michael Gen, a cardiac interventionist, slipped the tiny motor into her heart in about a five-minute procedure.
Her last memory before her heart stopped is a vague recollection of looking up a pattern for carving a pumpkin with her daughter on Halloween afternoon. “Apparently, I stayed home that night and passed out candy, but I have no memory of it,” she said.
Arbios defers to her husband, Stephen Dana, vice president of digital development and community relations at The Bee, for details of what happened early Nov. 1, and several weeks following.
Dana said he awakened to a sound he at first thought was Arbios snoring, which was unusual because she never snored. He realized she was gasping for air. He began CPR and called 911.
Paramedics arrived, after weaving their way through the Two Cities Marathon, and took over. They shocked her heart a couple of times to start it beating, he said.
Arbios was unresponsive when she arrived at the emergency department and doctors called Gen. He made the decision to implant the Impella. The heart pump could give Arbios, a young, healthy woman who had led an active lifestyle, a chance for her heart to recover, he said.
We waited about two days with this device inside her.
Dr. Michael Gen
“We waited about two days with this device inside her,” Gen said.
Arbios finally moved a toe, and a doctor saw it, Gen said.
As her medications were reduced, she squeezed Dana’s hand. She roused enough at one point to reassure her daughter, Sydney Schock, 12. “Traci just turned into a mom,” Dana said.
Doctors decided Arbios was a candidate for extracorporeal membrane oxygenation (ECMO), a treatment that uses a pump to circulate blood through an artificial lung back into the bloodstream. Dr. Peter Birnbaum, a Fresno cardiac surgeon, performed the operation. The ECMO machine replaced the Impella heart pump.
But Arbios’ condition remained grave, and she was airlifted to San Francisco, where she could be readied for a heart transplant. The time on the Impella and on ECMO had given her heart time to relax and recover, however, and she would not need a transplant.
“She really beat the odds,” Birnbaum said.
Arbios now has an internal defibrillator in her chest, implanted by Birnbaum, that will shock her heart should it stop beating.
She’s learned that she has familial cardiomyopathy, which is a weak heart muscle. Her father and her grandmother both died of the heart disease.
Arbios said she had symptoms: shortness of breath that she attributed to asthma, heart palpitations, a squeezing feeling in her chest, exhaustion. “I didn’t have screaming pain in my left arm. I didn’t grab my chest. These were constant symptoms.”
Arbios is thankful for Dana doing CPR to the disco rhythm of “Stayin’ Alive,” to the paramedics who got her heart beating and rushed her to Saint Agnes, and to the doctors who were there to take care of her.
But she also gives credit to a tiny heart pump.
“The amazing part is that without that, I would have died.”
Heart attack signs in women
▪ Uncomfortable pressure, squeezing, fullness or pain in the center of your chest. It lasts more than a few minutes, or goes away and comes back.
▪ Pain or discomfort in one or both arms, the back, neck, jaw or stomach.
▪ Shortness of breath with or without chest discomfort.
▪ Other signs such as breaking out in a cold sweat, nausea or lightheadedness.
▪ As with men, women’s most common heart attack symptom is chest pain or discomfort. But women are somewhat more likely than men to experience some of the other common symptoms, particularly shortness of breath, nausea/vomiting and back or jaw pain.
If you have any of these signs, call 911 and get to a hospital right away.
American Heart Association