DALLAS (AP) - After five heart attacks and a stroke, Charles Neal's heart was so worn out that he couldn't walk across a room without feeling exhausted and short of breath.
Constant fatigue caused by congestive heart failure eventually forced the 72-year-old business owner into early retirement.
"I used to go to work everyday, go on trips, but that quit two years ago, I couldn't stand up to it," said Neal, who owns of an underground fuel tank storage company in Arlington.
That all changed a few months ago when Neal underwent surgical ventricular restoration to have his enlarged left ventricle reshaped.
Using a new device called a Mannequin, doctors restored his round-shaped ventricle to its original oval-shape, allowing the heart to pump more efficiently.
The device - a plastic shaper - is a new approach to an old procedure that's been around for more than 20 years. What's different is that the shaper has now made ventricular restoration a standardized procedure for treating congestive heart failure.
"This is the only device to do this operation," said Dr. John Conte, the director of heart and lung transplants at John Hopkins University in Baltimore. "It allows a doctor anywhere in the world to do it the same fashion."
More than 5 million Americans suffer from congestive heart failure, and about 1,000 people die each day from the condition, typically seen in older people.
The disease develops when the heart is not pumping they way it should, causing the heart to work harder. This happens when the heart has been damaged or weakened by either clogged arteries, high blood pressure or a heart attack, causing the left ventricle to become enlarged.
Patients usually experience a range of symptoms, including shortness of breath, fatigue, persistent coughing or wheezing, and increased or irregular heart beat.
Doctors often treat the problem with medicine. Heart transplants also are an option but most heart patients are too old and too sick to withstand the surgery. Also, only 20 percent of people on the waiting list ever receive a heart.
Ventricular restoration appears to be a better treatment because it gets at the cause of their symptoms, can improve quality of life and perhaps help patients to live longer, doctors said.
During a two-hour surgery, the shaper is inserted into the left ventricle and then the heart wall is stretched around the device. Once the heart is molded to the right shape and inflated to the right volume, the device is deflated and removed. A patch is sewn onto the heart to maintain the shape.
So far, more than 700 patients in the United States have had the procedure since the FDA approved it two years ago. The procedure costs about $22,000 to $35,000 and is covered by Medicaid, Medicare and private insurance, said Bert Davis, president and chief executive of Chase Medical, a company based in suburban Dallas that manufacturers the device.
The procedure was pioneered by doctors in Italy, where heart transplants are not available. John Hopkins is the only training institution in the United States, but many have American doctors received training in Italy.
Dr. Paul Grayburn, Neal's cardiologist at Baylor University Medical Center in Dallas, said his hospital has done the procedure more than 25 times and with good results.
Neal, who had severely depressed heart function, is now walking 25 minutes on a treadmill without feeling exhausted and looks great, Grayburn said. "I think it also holds out promise for other patients," he said.
Ventricular restoration was first introduced as a way to treat ventricular aneurysms - a swelling of the heart. By the 1980s, doctors began using the procedure to treat congestive heart failure but "before the Mannequin, doctors had to do it by eyeball," Davis said. That meant some ventricles were made too small, too large or too spherical.
In 1999, Chase Medical began collaborating with Italian doctors to develop a device to help them achieve more precise and consistent results. The new device eliminates surgical guesswork when recreating the heart's original size, shape and muscle, Davis said.
Even though the surgery was risky for Neal because of his age and severe heart condition, he said it has allowed him to return to his once active lifestyle.
"The worst thing was I could die on the operating table, but I had reached a point in my life that I was so miserable, I would take any chance for quality of life," said Neal, a divorcee with three grown children.
He had the surgery along with six heart bypasses on his birthday, Nov. 6. It was the best present ever, he said.
"I can't tell you how great I feel," he said.
