Newswise — Underwater photographer Bob Wohlers appeared to be any cardiologist's dream patient. Aerobic fitness and a healthy diet were priorities in his life in order to maintain good cardiac health. Wohlers believed he was doing everything right to avoid the kind of debilitating heart disease he saw cripple his mother when he was young. It turned out he could change his air tanks easier than he could change his genes.
"My mom had extremely high cholesterol, up as high as 700 with LDL above 400 but I thought if I remained active and fit, I could avoid her fate. I thought I was bullet proof. I was wrong," Wohlers says.
One quintuple heart bypass surgery at 38 and a cabinet full of cholesterol-lowering drugs later, Wohlers was struggling with LDL or bad cholesterol numbers that were still dangerously high, thus increasing his risk of heart disease and even future heart attacks. Tests showed that he had a genetic abnormality which caused his LDL to climb many times higher than that of normal patients, and the usual treatments " exercise, diet, surgery and medication " were simply not working.
But today, Wohlers is undergoing something that is working " LDL apheresis. This treatment has allowed Wohlers' LDL to drop from a high of above 400 down to around 40 after a treatment.
Available at Cedars-Sinai Medical Center specifically for patients with genetic cholesterol abnormalities, LDL apheresis is considered a life-saving last resort for people like Wohlers, whose LDL levels remained dangerously high after all other treatments had failed. Originally developed in Japan nearly 30 years ago, LDL apheresis clinical trials were conducted throughout the 1990s in the United States with FDA approval coming in February, 1996. LDL apheresis is also currently Medicare approved.
According to Donna Polk, MD, Assistant Director of the Preventive and Rehabilitative Cardiac Center in the Division of Cardiology, and recently appointed Director of the LDL apheresis program at Cedars-Sinai Medical Center, on average this treatment takes between two and three hours twice a month during which time the patient's blood is essentially cleansed of LDL cholesterol with the HDL or good cholesterol and other bloodstream chemicals remaining intact. Following each treatment, Dr. Polk said that LDL levels could be lowered by up to 70 percent.
"This treatment somewhat resembles that for kidney dialysis patients or donating blood products (like platelets)," Dr. Polk explained. During treatment, blood is continuously removed from the patient's vein and passed through a machine that separates red blood cells from plasma. The blood cells are returned immediately to the bloodstream through a different vein while the plasma enters a filter that captures most of the LDL. The plasma is then returned to the patient without the LDL.
Reflecting on the two years he has been undergoing treatment twice each month, Wohlers said the only drawbacks are committing to and making time each month to get to the facility from Rancho Santa Margarita and the costs. But those factors pale in comparison to his results. "I have had two successful stress tests so far and my LDL levels continue to drop after each treatment," he reported.
In the U.S., there are 35 treatment sites offering LDL apheresis (with this type of procedure. An additional 50 undergo a slightly different procedure) with more than 150 patients currently undergoing treatment. At this time, eight patients are being treated at Cedars-Sinai, where the first patients in California were successfully treated with this procedure about three years ago.
By adding LDL apheresis to the treatment arsenal, the Division of Cardiology at Cedars-Sinai is making it possible for patients like Wohlers to have a chance of living a full and productive life and reducing the risk of life-threatening heart attacks in the future.
"LDL apheresis is available for patients who have very high cholesterol levels and are unable to maintain normal cholesterol levels despite a wide variety of previous treatments," Dr. Polk explained. "Happily, this gives them a way to beat the odds."
Cedars-Sinai Medical Center is one of the largest non-profit academic medical centers in the Western United States. For the fifth straight two-year period, Cedars-Sinai has been named Southern California's gold standard in health care in an independent survey. Cedars-Sinai is internationally renowned for its diagnostic and treatment capabilities and its broad spectrum of programs and services, as well as breakthrough in biomedical research and superlative medical education. Named one of the 100 "Most Wired" hospitals in health care, the Medical Center ranks among the top 10 non-university hospitals in the nation for its research activities.
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