THE Essex Cardiothoracic Centre (CTC) is the first in the UK to perform life-saving surgery on a heart attack patient using a new type of rapid cooling method.
Cooling, or therapeutic hypothermia (TH), involves reducing the body’s internal temperature to minimise swelling and damage caused to the heart muscle following a heart attack. It works much in the same way as a cold compress on a bruised arm – except the cooling takes place inside the body.
The quicker the patient is cooled before unblocking the artery, the less damage is caused by the heart attack.
The CTC is the only UK centre to be involved in the worldwide randomised trial for the ZOLL catheter called the Proteus.
Dr John Davies, consultant cardiologist at the CTC said: “When an artery is blocked the surrounding heart muscle dies. When we open up the artery, the muscle that has died is further damaged by the rapid reflow of blood – about half the injury to the heart following a heart attack is caused by this.”
Dr Thomas Keeble, consultant cardiologist at the CTC, added; “By cooling the patient before we open the artery, we can protect the heart and significantly reduce the amount of heart damage. It’s essential to do this quickly – we cool them from the inside but keep their outside warm, much like a baked Alaska.”
The first patient to be treated within this trial was Steve Jaggers, 50, who was at home in Laindon on Wednesday 6 July when he felt a pain in his chest and thought he had heartburn. His family gave him some indigestion tablets, but by the early hours of the next morning the pain was worse and had spread down his arm, and he knew something was seriously wrong.
The family drove to Basildon University Hospital A&E department, where he was quickly diagnosed as suffering a heart attack and rushed over to the CTC.
prevent this happening.
A ‘normal’ body temperature is 36.5 degrees. Within 18 minutes of Mr Jaggers being admitted to theatre, his temperature was 32.5 degrees and at its lowest was 31.7 degrees. The cooling therapy was initiated without any significant delay to treatment time.
Mr Jaggers, pictured left, said: “When they said I was having a heart attack I thought, ‘no I’m not’. It was so strange, everything happened so fast and once we were in the theatre everyone seemed to be talking to me. It’s a blur.”
A catheter with balloon is inserted from the leg in the main vein that runs through the body – the inferior vena cava. A cool liquid runs into the balloon and cools the body down from inside.
Shivering is a problematic side effect of cooling, so Mr Jaggers was wrapped up with warming blankets to
He was conscious throughout the procedure but says he didn’t feel any pain. He added: “It was such a strange sensation; I don’t know how to explain it. Inside I was cold. I felt like I was shivering inside, but I wasn’t showing it. It didn’t feel like me. It was a bit of an out of body experience. It was weird but nice.”
After the surgery, Mr Jaggers was warmed up slowly in recovery, by 1 degree per hour. He said: “It felt like being abroad in the sun, where you get hotter and hotter. I felt like my insides were being warmed from the outside. It seemed to take ages.
“Now I feel completely fine. It’s like nothing has happened to me. I’ve been treated really well here, like a king. A massive thank you to all the staff at Basildon Hospital and the CTC. Everyone, from the staff on reception at A&E who rushed me for treatment so quickly, to the expert team in the CTC, took the best possible care of me.”
Mr Jaggers is a maintenance worker at a care home, so is fit and active and has never had any heart problems before.
Consultant cardiologist Dr Reto Gamma inserted one stent into Mr Jaggers heart during the procedure. He explained the importance of not allowing the patient to shiver. He said: “If the patient starts shivering, their temperature won’t drop, so it’s imperative to cool them quickly, but carefully. The ZOLL machine helps do that in a controlled way.
“The trial aims to show the amount of heart damage following a heart attack is reduced when TH is used. MRI scans of the heart at 5 days and 30 days post-surgery, should reveal the outcome. It is a 50-patient trial and we are the only UK centre to be taking part.”