Heart failure patient says treatment '100 percent better' with new ultrafiltration system

Congestive heart failure.

When he first heard the diagnosis in 2002, Steven Parris felt as you might expect: "It was a rough day. I wasn't sure what kind of future I would have–or if I even had much of a future," says Parris, 51, a University of Iowa employee, history buff, and longtime New York Yankees fan who has lived in the Iowa City area with his wife, Natasha, since 1995.

The diagnosis sounds immediately severe, as if the heart could stop beating any moment. But although it can be life-threatening, many people are able to manage the condition. Heart failure usually means the heart's ability to pump blood has weakened to the point that it can't circulate enough to meet the body's needs. When fluid builds up within the body due to the condition, heart failure is called congestive.

The traditional therapy to handle such cases of fluid buildup is diuretic drugs (generally taken intravenously at the hospital and orally at home), which cause the body to lose water–with some notable drawbacks.

"Diuretics can impair kidney function and alter the balance of electrolytes (such as potassium and sodium)," says William Haynos, M.D., a heart failure expert with UI Heart and Vascular Center at University of Iowa Hospitals and Clinics. "They have also been demonstrated to alter the physiology of patients such that their heart failure worsens. And registry data suggest that many heart failure patients go home after diuretic treatment without having lost much water–so the drugs don't always work well.

"Plus, the body seems to develop a tolerance to them, necessitating larger doses and longer hospital stays (patients on diuretics are often hospitalized for many days and have recurring visits). This quickly becomes a financial burden on top of the physical one. With heart failure cases increasing nationwide, therapies are being targeted at reducing frequent and long-lasting hospitalizations," Haynos says.

One such therapy now being used at UI Hospitals and Clinics is known as ultrafiltration. Using the Aquadex™ FlexFlow™ advanced fluid removal system, physicians are able to remove excess water from heart patients in a manner similar to dialysis, the method through which kidney failure patients have excess waste products removed.

UI Hospitals and Clinics was the first center in Iowa to acquire the FDA-approved Aquadex system, which is hooked to the patient via IV. It can safely remove up to four liters of fluid in an eight-hour period. Ultrafiltration has been known as a fluid removal option for half a century; however, until recently, a device to make the technology available for widespread use has been lacking.

"I was initially worried that the machine would be a headache to use," Haynos says. "But it's the exact opposite. Once you type the correct information into the machine, you know exactly how much fluid will be removed (unlike with diuretics), and you can control the speed. It's a predictable, controlled treatment that shows potential to reduce the rate of re-hospitalization significantly."

Parris says, "The ultrafiltration process, from my perspective, is much better. Other than having to be in the hospital for a couple of days, it is ideal. I felt no ill effects from using the process and my fluid level did decrease, though they had to stop it early due to my liver function taking a hit for the worse. It subsequently recovered to previous levels. Overall, I would say this process is 100 percent better than diuretics."

For more information about ultrafiltration, patients and physicians may call the Heart Failure Treatment Program at 319-356-1028.

Welcome Relief
Heart failure patient Steve Parris (above) experienced welcome relief from the effects of cardiac fluid build-up, thanks to UI Heart and Vascular Center's advanced fluid removal system (blue device shown at left). With Parris are heart failure specialists William Haynos, M.D., and nurse managers Kim Lopez, R.N., and Kimberly Chamberline, R.N.

The Aquadex™ system removes excess water from heart patients in a manner similar to the way dialysis helps patients with kidney failure.