CDC Update: What Should You Know About Heater Cooler Machines, Infections & Heart Surgery?
By Adam Pick on November 8, 2016
In case you missed it… There was a very important CDC update recently that addressed a potential link between heater cooler machines and infections for heart surgery patients. My goal with this post is not to alarm you. Instead, with the help of Dr. Raymond Singer, chief of cardiac surgery at Lehigh Valley Health Network, and the CDC, I want to educate you about this development.
That said, I filmed this video with Dr. Singer to discuss several key points that patients should know about heater cooler units and a potential infection that results from nontuberculous mycobacteria. For more, watch this video…
In addition to the Dr. Singer’s comments, I also wanted to share this video that was posted by the CDC about heater cooler machines and the potential bacteria that may infect heart valves.
Again… My goal with this post is not to alarm you or scare you out of having heart surgery. As Dr. Singer suggests, heart surgery remains safe and that many clinicians, companies and agencies are working together to manage this situation appropriately.
Keep on tickin!
P.S. For the hearing impaired members of our community, I have provided a written transcript of my video with Dr. Singer below.
Adam: Hi, everybody. It’s Adam with heartvalvesurgery.com. We’re coming to you live from the Heart Valve Summit in Chicago, Illinois. I’m thrilled to be here with Dr. Raymond Singer, who is the chief of cardiac surgery at Lehigh Valley Health Network in Allentown, Pennsylvania. Dr. Singer, thanks for being here.
Dr. Singer: Adam, great to be here.
Adam: We were just talking, Dr. Singer, about a recent CDC release, and I was hoping you could help educate and make our community aware, all the patients out there, about what you recently learned.
Dr. Singer: That’s right, Adam. It turns out the CDC, or Centers for Disease Control, released an advisory to patients and to hospitals and doctors, and the FDA has also released recommendations, regarding a somewhat unusual infection that may be related to people who have had open heart surgery. It turns out that there is an organism known as NTM, which stands nontuberculous mycobacteria. That’s different than tuberculosis itself. These organisms may be associated with a machine that is often used in open heart surgery.
Now, it turns out it’s not actually the heart-lung machine, but it’s a machine known as a heater-cooler device. When we do open heart surgery, we often have to lower the patient’s body temperature down and then rewarm them. This is a device that was made in Germany, and this device contains water. It turns out that these organisms are somewhat ubiquitous in all of nature. They’re in the ground; they’re in water. It may be the case that this particular device that was made in Germany may have been contaminated during the production cycle.
Now, what is the risk to you? It turns out that patients who have had open heart surgery may have been exposed to this organism. That doesn’t mean that you necessarily are infected; however, there have been reports of infection. Now, the CDC believes that the infection rate can range from anywhere from 1 in 100 patients to 1 in 1,000. One of the key factors are whether or not the patient has immunocompromised state. Patients who have immunosuppression or immunocompromised for one reason or the other are more at risk for developing an infection.
One of the problems, Adam, is that these infections can be very insidious. It may take months or even years to show up. Sometimes patients may not realize that it’s due to this particular infection. The symptoms can be as simple as fever or malaise, or it can be as serious as infection of a heart valve or even infection of your liver.
What should you do? If you’ve had open heart surgery, it is likely that you’re going to receive a letter from the hospital where you had your open heart surgery. That shouldn’t get you alarmed. It doesn’t mean that you are infected. It turns out that there is not a screening test to determine if you’ve been exposed. However, if you have developed an infection, your doctor can do a test to determine if that infection is due to this nontuberculous mycobacteria infection.
The other thing I want to reassure all of your patients is that having open heart surgery today is very safe, in fact, probably now today more safe than ever because of the FDA recommendations not only on the machine, but how to maintain the machines going forward, and how to do the proper cleaning. There is a lot of other advice that the FDA is giving, and all hospitals around the United States are adhering to this advisory.
The bottom line is it’s a concern. If you have a concern, contact your doctor and/or hospital, and please go forward. Open heart surgery is still safe, and we are paying attention to these developments.
Adam: Dr. Singer, thank you so much for bringing this very important topic not just to me here at the conference, but to all the patients in our community, and giving us the reassurance to know that open heart surgery is still very safe, and that the FDA, the clinical teams, are working to fix this issue and address this issue. Thank you so much for what you’re doing.
Dr. Singer: It’s my pleasure, Adam. Thank you for all you do for our community.
Adam: Thanks so much. As we always say here, Dr. Singer, keep on ticking.