today • Wednesday 9 January 2013
22
health
medical innovation
New pump offers hope to heart failure patients
SINGAPORE — A 57-year-old patient with
advanced heart failure has become
the first person in Singapore to be implanted with a new miniaturised heart
assist device to manage her condition.
The device, known as HeartWare
Ventricular Assist Device (HVAD), a
third-generation heart pump the size
of a golf ball, has helped retiree Helen
Tan go about her daily activities like
climbing the stairs or bathing without feeling breathless. Without the
implant, Madam Tan would have had
about a year to live, her doctors said.
The four-hour open heart surgery
performed on Mdm Tan on Sept 26
last year was an hour or two shorter
than the procedure needed to install
an older-generation heart pump because a “pocket” would have had to
be surgically created to fit the latter.
HVAD acts as a “bridge” to heart
transplant for patients who have advanced heart failure who do not respond to medication at the end stage
of the disease, and patients who require long-term support, said the
National Heart Centre Singapore’s
HVAD has
a track
record of
5
years
based on
clinical trials
and is more
suitable for
‘smaller-sized
patients’
Heart Failure Programme Co-director, Dr David Sim.
While the older device has a track
record of up to 10 years and could be
more suitable for patients who need
long-term therapy, HVAD, with a
track record of five years based on
clinical trials, is more suitable for
“smaller-sized patients”.
“There is also potentially a use for
it (HVAD) to support both the left and
right side of the heart, while the second and older generation of pumps can
only support the left side,” said Dr Sim.
However, the new pump costs
S$160,000, and the costs could balloon
to S$300,000 if a three-week hospitalisation is factored in. But government subsidies of up to 80 per cent are
available. Mdm Tan, for example, paid
S$16,000 after government subsidies
and her personal insurance.
Some 5,000 patients here suffer from heart failure, with 13 on the
waiting list for a heart transplant.
The National Heart Centre gets about
25 heart donations a year but only two
or three are suitable. Ashley Chia
Ms Elaine Poh sought treatment for an ankle sprain but discovered she had a ruptured
ligament and peroneal tendon tear through an MRI scan. PHOTO: DON WONG
There may be more serious
injuries behind sprained ankles
SINGAPORE — Ankle sprains may prove
to be more sinister than first thought,
a National University Hospital (NUH)
study of 50 patients has found.
Besides lateral ligament injuries,
which are commonly associated with
ankle sprains, seven in 10 patients surveyed were found with injuries that included swollen bones, inner ligament
injury, cartilage injuries and bone
marrow edema after being given an
MRI scan.
Only 13 patients in the study, conducted between January 2011 and November last year, suffered lateral ligament injuries solely.
The finding lends weight to a belief that traditional methods of treating ankle sprains — rest, ice, compression and elevation — may not always
work for everyone.
“There are many possible reasons
why people do not recover as well as
they should; it could be due to their rehabilitation or other injuries not related to ligament injuries,” said Dr Tan
Ken Jin, a Consultant at the NUH’s
Division of Foot and Ankle Surgery,
who led the study.
With an MRI scan, however, doctors will be better able to counsel their
patients on their rehabilitation and expectations for recovery, he added.
The scan may also give some form
of assurance to patients or inform
them of the severity of their injury,
said Dr Tan.
Ms Elaine Poh, 28, found out
through an MRI scan that she had a
ruptured ligament and peroneal tendon tear from an ankle sprain about
10 years ago.
“I was a little surprised at the result because I didn’t realise that it was
a big injury,” she said.
Ms Poh underwent surgery shortly after the scan to repair her injured
ligament and tendon.
Even with the results of the study,
an MRI scan, which can be costly, is
still an option for patients rather than
being standard practice, said Dr Tan.
However, doctors say an MRI is
recommended for those who suffer a
bad sprain, lead a sporty lifestyle or
who have demanding jobs that do not
allow them time to undergo physiotherapy. Then Ai Ping