Originally created 04/22/01

New heart device thwarts blockages



The first time her chest pains drove her to the hospital, Sandra Malone had no warning and ended up with quintuple bypass surgery.

But this time, Mrs. Malone was able to have a much less invasive procedure to open her clogged arteries and is getting a new device that is more likely to keep those arteries open. This time, she knows exactly where her problem came from.

"I'm a waitress at Huddle House," said Mrs. Malone, 57, of Thomson. "That's probably what clogged my arteries up."

Mrs. Malone is one of the first area patients to receive a new kind of stent, or metal coil, delivered into a clogged heart vessel to hold it open after balloon angioplasty. What is different about this stent is it is coated with heparin, an anti-coagulant that might help prevent clotting which could close the artery back up.

Stenting by cardiologists has been done for years to try to keep an artery from closing off again. Unfortunately, the metal coil itself sometimes caused a reaction to factors in the blood that caused a clot to form and choke off blood flow, a problem called restenosis. In earlier studies, the heparin-coated stent cut the restenosis rate from about 22 percent to 10 percent in blood vessels of 3 millimeters in diameter or larger, said cardiologist Brian Phelan of Augusta Cardiology Clinic. University Hospital is one of the first 75 centers in the country to get it, and Augusta Cardiology is part of a study using the stent in smaller-diameter blood vessels, although every cardiologist at University has access to it, said cardiologist Les Walters of Augusta Cardiology.

Other stents, coated with or exuding other drugs, are under development, Dr. Walters said.

"This is introducing the first coated stent, which you're going to be hearing a ton about in the next couple of years because that's where all the research is going," Dr. Walters said.

Cardiac catheterization has an advantage over open-heart surgery because it requires only a small incision in the leg to thread a long thin wire, or catheter, up to the heart.

"We're a lot safer than bypass up front," Dr. Walters said. "Our Achilles' heel has been restenosis."

The coated stent might be the answer to "what can we do to not only be safe, quick and get people back on their feet but keep those results long term," Dr. Walters said.

Cardiologists, in fact, are becoming victims of their own success in that they are keeping people with cardiovascular disease alive longer and are now doing procedures on patients who are sick and with more complicated problems, Dr. Phelan said.

"We've altered the natural history of the disease," Dr. Phelan said. "We weren't seeing people survive this long. But what we're seeing poses incredible challenges."

Now suffering congestive heart failure, Mrs. Malone has received two of the new stents in the past two weeks and said there is no comparison with her bypass surgery, when she spent eight or nine days in recovery. This time, she is headed home the next day.

"I feel a lot better," she said. And she's swearing off the fried foods.

Reach Tom Corwin at (706) 823-3213.