Breakthrough Procedure Performed at Deborah

At the end of December interventional cardiologist Dr. Christine Gasperetti made local medical history when she performed an angioplasty on Joseph Genovese of East Windsor, using a brand-new device called TandemHeart. Deborah is the only hospital in New Jersey currently doing this procedure.

Since then, the hospital has used the device twice more. The third time marked the 500th milestone for the device’s use nationwide, according to the Pittsburgh-based CardiacAssist, the device’s manufacturer.

TandemHeart is an ingenious device that makes it possible for people like Genovese who are considered too high risk for traditional heart surgery to undergo an angioplasty safely. In angioplasty, a balloon-tipped coil is inserted into an artery through a thin plastic tube (a catheter). The balloon is then inflated to break plaque and clear blockages.

The TandemHeart device is a mini-pump that sits on the patient’s thigh. Catheters run through the skin and into the heart allowing the pump to take over about 85 percent of the heart’s pumping function while the doctor is performing an angioplasty and putting stents, or wire mesh tubing that braces arteries open, in place.

For a patient like Genovese, the device was a life-saving innovation. “This procedure can be used for high-risk angioplasty patients,” said Dr. Gasperetti. “It significantly broadens the spectrum of patients who might otherwise not be candidates for revascularization.”

During traditional angioplasty, blood flow in the heart is momentarily stopped. For low-risk patients this usually presents no problem. But for someone like Genovese, who had a double-bypass in 1997, a TMR (transmyocardial revascularization) in 2001, and now had three blockages in his heart, one of which stopped 90 percent of the blood flow in his left main artery, he was not considered a candidate for another surgery.

With the thin tubes in Genovese’s heart pumping his blood, Dr. Gasperetti had a safety back-up while she did three procedures in succession: a “kissing” balloon angioplasty inflation to make room for the stents, the insertion of drug-coated stents simultaneously into two branching pathways off the left main artery using “kissing” stent technique, and a further high pressure balloon inflation to further expand the stents. The procedure was all done within two hours. Genovese was off the pump – his “tandem” or second heart – within three hours.