Al Saint Jacques, MDLinx | March 05, 2017
A man from Whitehall, Ohio is the first in the United States (US) to receive a new treatment designed to remove excess fluid from hospitalized patients who have congestive heart failure (CHF). The procedure was performed last week at The Ohio State University Richard M. Ross Heart Hospital in Columbus, OH.
Ohio State is the first institution to conduct the procedure and, with Advocate Christ Hospital in Chicago, is one of only two test sites in the US.
In the study, researchers examined the safety and feasibility of inserting a catheter that was designed to remove excess fluid from the lymphatic system. Lymphatic vessels help remove fluid from tissues and return it to the body’s circulation system, researchers explained. This excess fluid is then eliminated by the kidneys. The lymphatic system typically drains up to two gallons of fluid per day. In acute CHF, this process is restricted, allowing fluid build-up, or edema, to occur in the lungs and other areas of the body. Edema is a major symptom in heart failure, and this novel therapy was created to treat one of the underlying causes.
“Most of the recent advancements in heart failure have been for non-hospitalized patients to help keep them well,” explained Sitaramesh Emani, MD, a cardiologist and director of heart failure clinical research at Ohio State University, who performed the procedure. “We need new therapies for patients once they’ve become hospitalized. There hasn’t been a lot of new development there.”
Raynes Rozzelle, 61, has lived with various heart issues most of his life, from a heart murmur to an irregular heartbeat, and then he had a heart attack four years ago. He has been in and out of the hospital with CHF for about a year. He says he readily agreed to try something new.
“I thought, not only could this possibly help me, it may end up helping a lot of other people. I was raised to help others whenever you can,” Rozzelle said.
The treatment was developed by WhiteSwell Medical of Herzliya, Israel, and is the first known catheter specifically designed to target the lymphatic system internally. This catheter device is placed in the neck under ultrasound guidance in the catheterization lab, and the treatment continues at the bedside using a machine that helps circulate some of the blood.
The current in-hospital treatment for CHF involves removal of excess fluid with diuretic medication and/or ultrafiltration in which a machine bypasses the kidneys and filters water and salt from the body. However, these treatments can have unwanted side effects such as low blood pressure and worsening kidney function.
“In some cases, the diuretics provide only partial relief, so there’s a need for new options for treating the congestion associated with heart failure,” said Garrie Haas, MD lead investigator on the study and director of the Ohio State advanced heart failure program. “More efficient and effective treatment not only improves the patient’s quality of life, it can reduce re-hospitalizations, so we’re interested in trying this new approach.”
According to the Centers for Disease Control and Prevention, heart failure is the most common reason for hospital admission in those patients age 65 and older, and it accounts for one million admissions each year in the US.