In a heart attack, everything must go fast. Parts of the heart are not getting enough blood. Oxygen and nutrients missing, heart muscle cells may die – sometimes with fatal consequences for the patient. But even if it is to act in time, damage may remain. Parts of the heart muscle may be permanently impaired in its pumping function
The Vienna start-up Miracor has developed a novel system and will reduce damage resulting from a heart attack. Cardiovascular diseases – including heart attack or stroke count – are the leading cause of death in Austria. The importance of cardiovascular disease the World Heart Day aims to raise awareness on next Monday.
No blood in small vessels
If a heart attack on can be performed as a therapeutic cardiac catheterization. Here, the doctor recognizes the closed vessel, and can be engaged by opening it out mechanically. This means that the vessel does not close again, placed one stent: The fine, tunnel-shaped grille – often metal – serves as a vascular support
But in the tissue after closure occurred shortly after the heart attack changes.. “The small blood vessels have the property that they close themselves, such as glue. Even if the stent is introduced, flows into it, no blood, “says Miracor CEO Ludwig gold. “After forty hours from the tissue dies.” The damage remains.
“In about two thirds of patients with a heart attack, which closes the whole vessel, the supply of small vessels is despite successful acute therapy, moderate to bad, “says Gold. “This group of patients will benefit most from the new therapy.”
But how does the new system? The technology is called PICSO and stands for Pressure-controlled Intermittent Coronary Sinus Occlusion. The system comprises a cardiac catheter, and an operator console. It does not replace existing therapies, but to complement them.
access in the groin, a catheter is inserted into a vein and advanced to the heart. Placed the catheter, where the vessels that supply the heart muscle, back into the bloodstream – more precisely in the right atrium – open. Finally, there is a balloon is inflated, closing the vessel. The pressure in the heart vessels is increasing. As the balloon is located behind the original closure, while the pressure in the previously sealed container. The system changes regularly, the pressure conditions. It builds up the pressure in the vessel up and down quickly. This is accomplished by inflating the balloon, and exhausting and lasts between eight and fifteen seconds. Be carried out more closure cycles, the system operates completely automatically.
The therapy lasts a total of 30-45 minutes, the duration of treatment depends on the patient. “The technology is patient-oriented,” says Gold. The system measures simultaneously with the closing cycle data such as pressure and flow values of the patient and adjust the therapy accordingly
The system reach you three different effects, says Gold., The small vessels, which let in no more blood , be opened by the higher pressure. “We bring blood in those border areas would flow more in the none,” says Gold
A second advantage of the therapy is the so-called wash-out. Due to the lack of supply of the heart muscle caused pollutants. The new technology removes them faster. The pollutants caused by the lack of supply of tissue with blood and can affect it further
The development team also observed long-term effects:.. Formation of new blood vessels is supported by the technology
in partial obstructions of vessels it also came so far to do so by the sudden opening of the occluded vessel that the area behind it partially took damage. By the difference in pressure is regulated, the damage can be reduced
All in all, we have an important result observed. “We can use the new method to save more heart muscle tissue than with a stent,” says Gold. ” / p>
The company currently focuses on serious heart attacks, in which the whole vessel is closed. In future it is hoped that the system finds application also in bypasses and heart failure. For the treatment of heart attacks, the technology has been tested in Europe already in 160 patients in several centers.
The medical device has been certified by an external body. Until it is fully used in the hospitals, some steps are still open: For the treatment is paid for by health insurance, more studies need to be performed. “We are currently planning for next year a large study at multiple centers,” says Gold. The study included 300 patients will participate. One half is replaced by the new therapy, and the second is a control group. Currently, the centers are prepared for the study. Gold expects that in three to five years in Austria, a cash refund may occur.
Miracor was founded in 2008 and currently employs 15 people. The developed technique is by Werner Mohl, heart surgeon at the Vienna General Hospital and a professor at the Medical University of Vienna. In addition to private investors promote Austria Economic Service (aws), Research Promotion Agency (FFG), the Center for Innovation and Technology (ZIT) and Euro Stars technology. [Corbis]
A heart attack occurs when a coronary artery clogged. Coronary arteries are responsible for supplying the heart muscle. By the infarct tissue is not adequately supplied and begins to die.
In a cardiac catheterization , a guide wire is inserted into the blood system and advanced to its destination. As part of the investigation closed vessels can be opened again.
The system of Miracor used a balloon. It closes for a short time, the vessel, which is after the congested place. This creates an increase in pressure, and small vessels can be perfused by opening the shutter again
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(“The Press’ print edition, 27/09/2014)
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