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HEART ATTACK CELL SAVER Within 20 minutes of a heart attack brought on by a blockage, heart muscles begin to die. That's why current treatment involves getting patients to the cardiac

catheterization lab quickly, where clot-busting drugs and an artery-opening balloon are inserted. Yet nearly a third of patients who survive a heart attack go on to develop heart failure

within five years, according to Buckberg, because the injured heart muscle is too dysfunctional to pump efficiently. What might help? A technique developed by Buckberg called controlled

reperfusion that aims to salvage the cells around the dead area when they are barely functioning but still alive. A solution of potassium, dextrose, lidocaine, amino acids and other

chemicals is delivered to the heart in precise ways at the same time the blockage is opened. “By reperfusion of these ingredients, we nourish and save more heart muscle around the dead

middle tissue,” Cox says. A study of more than 150 patients found that using the procedure dramatically reduced the five-year death rate after a heart attack. Buckberg conceded that adding

this method requires cardiologists and surgeons to develop new skills, and it increases costs. But, as he wrote in his book, “markedly superior clinical outcomes could result from this

innovative treatment.” HEART FAILURE PREVENTER Doctors learn in medical school that the heart is like a mechanical pump, but more specifically, its left ventricle twists in an elliptical

direction with every beat, which allows for fuller blood emptying, Allen says. That torque matters, he says, just like it does for a football toss. Constantine Athanasuleas, professor of

cardiothoracic surgery at the University of Alabama at Birmingham, along with colleagues, developed an operation for patients whose left ventricle has lost this natural shape following a

heart attack. Known as surgical ventricular restoration (SVR), it aims to reconfigure the damaged ventricle by positioning a patch inside. Results published in the _Journal of the American

College of Cardiology_ in 2004 on a study of 1,200 patients found that the vast majority not only improved their heart function but did not require any hospital readmissions for five years

after the procedure. Thousands of other patients were similarly treated around the world. But other results from a multicenter randomized trial, published in 2009 in the _New England Journal

of Medicine_, failed to show any benefit. Athanasuleas and others blame the trial's design, which allowed surgeons without experience in the method to participate and included patients

without any left ventricle dilation to fix. “The trial was flawed, but the headlines cardiologists took away from it was that the surgery won't help,” Athanasuleas says. He's

hopeful the idea that the ventricle should be brought back to its elliptical shape after a heart attack will make a comeback, now that a minimally invasive implant is being studied that

could accomplish this goal with lower risks. Other doctors say that more research is needed but that this procedure could be valuable further down the road.