Wednesday, May 5, 2010 2:36 PM

World's smallest heart pump used for first time in Valley

Tim Volk, a 51-year-old ex-Marine and nuclear engineer, was facing the prospect of a risky third open heart surgery after blockages were again found in arteries leading to his heart. But cardiologist Bipin Joshi offered him another choice with a new technology – the “Impella” or world’s smallest heart pump.

The tiny device – used for the first time in the Valley on Volk at Community Regional Medical Center – acts the opposite of a boat’s propeller. It’s slightly smaller in diameter than a No. 2 pencil, about a third as long and is inserted into the heart via catheter from an incision in the groin. Once in the heart, the Impella pulls blood out of the heart’s chambers, propelling blood to the rest of the body. It can stay in after surgery to help patients recover.

“The Impella provides an assist during risky procedures,” explained Dr. Joshi. “Without this the heart might stop or it might not be able to pump well enough and that would be a disastrous situation. This gives us the time and support to do what we need to fix his heart.”

After studying the Impella’s technology and reviewing his options, Volk said he was more than willing to be the first patient in the Fresno region to try it. “This technology is so amazing,” he said, “that I called several friends and told them they needed to invest in this company.”

Volk’s had several heart attacks, two surgeries to do multiple bypasses of blocked arteries and stents put in other blocked arteries. And still, just months after his last surgery, he was experiencing chest pain and shortness of breath.  “He’s a very smart guy and he takes his medications well. He just has genetics we don’t understand,” said Dr. Joshi.

For the historic first Impella implantation, two cardiologists, three cardiology residents, four cardiac technicians, and four cardiac intensive care nurses gathered in Community Regional’s cath lab to watch and assist. The world’s smallest heart pump went in easily and took just a small adjustment to get pulled into the optimum spot for pumping blood.

The academic regional medical center partners with top medical school UC San Francisco to train 200 resident physicians annually in the Fresno Medical Education Program.  Nearly a third of family practice physicians and specialists practicing in the Valley were educated through this program.

“It’s a new era at the cath lab,” declared Dr. John Ambrose, director of cardiology at Community Regional and a UCSF clinical professor, as he and Dr. Joshi finished opening a critical blockage in Volk’s artery.

“I’ll absolutely use it again,” Dr. Joshi said afterwards. “The Impella did just what it was supposed to do. Now we’ll able to do more high-risk cases more safely for our patients.”

This story was reported by Erin Kennedy. She can be reached at