Do you know what heart failure is? (Hint: It's probably not what you think)

The second time Mercado landed in the ER because of his heart, the news wasn’t good, at least not at first. He was in Stage D of heart failure. “My doctor told me that I had multiple blockages in my arteries and that my case was high risk,” Mercado recalls. He was relieved to learn that instead of surgery, he might be a candidate for a minimally invasive cardiac catheterization procedure to unblock his arteries with the help of an Impella heart pump.

While some people with heart failure can be treated with medications that can slow a too-rapid heart rate, control blood pressure and reduce fluid in the body, “not all patients can tolerate these prescriptions because their blood pressure may be too low, or their kidney function might be compromised,” says Dr. Chapman. Others may be too sick to make them good candidates for surgery if they have multiple blockages or comorbidities such as obesity or diabetes.

In the past, the only option for these high-risk patients was to get on a waiting list for a heart transplant. But recent studies, including one in the International Journal of Cardiology, suggest that patients who receive the Impella heart pump before procedures such as cardiac catheterization—as opposed to during or after—have significantly lower short-term and mid-term mortality rates. One reason is that the Impella heart pump assists the heart and decreases its workload while maintaining blood pressure, allowing the heart to rest and recover and making it possible for doctors to perform procedures earlier.

“Think of it like having a twisted ankle—in order to heal, you need to rest and not put weight on it,” says Sonya Bhavsar, Ph.D., Director, ECP and Pediatric Platforms, Abiomed. “Similarly, your heart is a muscle that is always working. When it is injured or compromised, it’s not able to rest because your body depends on it,” she adds. “Impella is like crutches for the heart—it takes the load off.”

And unlike older, bulkier heart pumps, which can potentially damage the heart muscle, “the Impella pump is inserted during a minimally invasive procedure,” explains Bhavsar. “The pump is inserted percutaneously, meaning through the skin, using a small puncture to reach a large blood vessel in your leg. It is similar to when a technician uses a needle when you are giving blood. Once in position, the pump sits across the aortic valve, pushing blood through the valve in synchrony with the heart, working with it hand in hand.”

The Impella can remain in the body for just a few hours, as was the case for Mercado, while his doctor unblocked his arteries, or for up to 14 days as the patient continues to receive treatment.

Looking back, Mercado says the difference between his treatment experience in 2010 and 2022 was dramatic. “The first time, my chest was open, and there was mesh in there,” he says. “This time, I was awake during the whole procedure, and my doctor even showed me images of my arteries as he was removing the blockages. I was home from the hospital in two days.”

Today, he is back to working out again and enjoying the things that make him happy, like spending time with his family and dancing. He’s also down 70 pounds from his high of 340 and is mindful that he needs to stay tuned into his body’s signals. “I know how important it is to get checked if you feel symptoms,” he says. “The worst thing to do is to wait until the last minute.”