Kansas man goes home with experimental heart pump after 9 months in ICU

It took a record nine months in intensive care at Barnes-Jewish Hospital in St. Louis, but a Shawnee, Kan., man will be back home Saturday, thanks to an experimental heart-assist device that keeps his heart pumping.

Guthrie, 61, who has end-stage heart failure, was waiting at home for a heart transplant. But when his condition "profoundly deteriorated" last fall, he was airlifted to Barnes-Jewish for a temporary mechanical heart pump, "to see if he would turn around," his physician, Nader Moazami, said.

"I told the family he has a 90 percent chance of dying," said Moazami, surgical director of the hospital's and Washington University School of Medicine's heart transplant and artificial heart programs.

The mechanical pump, an external device that can only be used in an ICU, is intended to support a patient for a month or two. Over the next few months, his liver function and breathing recovered enough that Guthrie was ready for the next step. But what?

Guthrie's small stature made him unsuitable for larger heart pumps, which would not have fit into his body. The only option was the smaller HeartMate II pump, which wasn't approved by the FDA, and Guthrie's insurance company wouldn't pay for it initially.

Through a series of letters and phone calls to the FDA and Humana Health Care, Moazami was able to persuade them to allow the compassionate use of the experimental device for Guthrie.

Once the new device was implanted, Guthrie recovered remarkably. His kidney function and physical strength returned, and he got out of the ICU. He has not yet regained his appetite, but "given what he's been through, this is minor," Moazami said.

Barnes-Jewish doctors are familiar with HeartMate II because the hospital is one of the institutions participating in the clinical trial.

A small pump implanted in the body, it is attached to a half-inch cable connected to a battery pack that recharges it. It's mobile. Moazami said one of his patients in the clinical trial delivers pizzas.

The device will stay inside Guthrie, and he should do well, as long as it's durable perhaps as long as five years. When it fails, he'll either get a replacement or be considered for a heart transplant.

Barnes-Jewish is the only heart center in Missouri that offers Thoratec Corp.'s HeartMate II and a wide variety of other devices tailored to patient needs, Moazami said.

•	Kansas man goes home with experimental heart pump after 9 months in ICU Associated Press, Friday, July 20, 2007 Byline: Cheryl Wittenauer