Scott Webb (Host): Today, we're going to learn about TherOx Supersaturated Oxygen Therapy, SSO2 therapy, from Dr. Donald Yakel. He's a Cardiologist with Carle, and he's going to tell us about this revolutionary system and how it's not only helping to save lives, but also spare patients' hearts from lasting damage after a heart attack.

 Welcome to Let's Talk with Carle Health, a podcast featuring Carle doctors, partners, and other experts bringing you topics important to your health and wellness. I'm Scott Webb.

Doctor, thanks so much for your time today. We're going to talk about Zoll TherOx SSO2 therapy, and that's a mouthful, and I don't really know what it means. So it's great to have you and your expertise here to explain this to me and to listeners. So let's start there. What is the TherOx supersaturated oxygen or SSO2 therapy?

Donald Yakel, MD: So TherOx SSO2 therapy, it stands for super saturated oxygen therapy. So what it does is it adds oxygen to the plasma of the blood so that that oxygen can be delivered to heart muscle that has been damaged from a heart attack. So heart muscle that no longer receives enough blood flow because of a blockage in a heart artery, we can get oxygen to that muscle to prevent it from dying while the heart attack area is healing.

Host: Yeah, it sounds pretty revolutionary, wondering, like other than, you know, as you're saying, being able to get oxygen where it needs to go so people can, you know, live and survive, what are the main benefits of the therapy?

Donald Yakel, MD: So when somebody comes in with a heart attack, it's literally just a blood clot within their heart artery, which is just a pipe that's carrying blood to their heart muscle. So what we initially do is we open that pipe using standard balloon angioplasty and stents, which opens the artery. The oxygen then is delivered to the zone of infarction or the area of the heart muscle that is dying or dead.

And it takes a while for the very small arteries to open up. It can take hours, if not a day or two. So what the main benefit of this therapy is, is it's able to deliver oxygen to these very small arteries, very small areas of the heart muscle that otherwise wouldn't get the oxygen early on, and that prevents the heart attack from enlarging. So in other words, it decreases the size of the heart attack or the size of the damage done to the heart muscle.

Host: And I know they say time is brain with stroke, and time is heart, and time is certainly of the essence. It sounds like this really helps patients who've experienced a heart attack, you know, specifically, I guess, what they call the Widowmaker type heart attack.

Donald Yakel, MD: That is correct. So the Widowmaker, traditionally is this is the anterior descending artery, the big heart artery down the front of the heart, so it serves the largest amount of heart muscle. So, the way this helps patients is when we open up that artery, there's a large zone of heart muscle that's at risk. If more than 40 percent of the heart muscle is involved at any one time, the heart muscle or the pump for that patient will usually stop. So by opening up the artery quickly and then getting super saturated oxygen to the zone of infarction or the area of dying heart muscle, decreases the size and the amount of heart muscle that dies. So we're able to prevent the heart muscle pump from dying off.

Host: Right. Yeah. And even as a lay person, I can certainly understand the value of that. Right. So who's eligible to receive TherOx supersaturated oxygen, you know, the SSO2 therapy, is it anyone who's in heart distress, specifically, or they have to be having a heart attack? Who are the real benefits?

Donald Yakel, MD: So my, suspicion is eventually this is going to become mainline therapy for most patients coming in with any heart attack. Right now, it's new and the indication from the studies that have been done so far is that you are eligible if you present to the emergency department with a heart attack in under three hours. And that heart attack involves the anterior descending artery or the big artery down the front of the heart.

Host: Yeah, I see what you mean. It's, and I have the pleasure of hosting a lot of these medical podcasts and I'll hear about things that aren't quite the gold standard for everything yet, but you get this sense, especially a sense from experts like yourself, that it probably will be in fairly short order.

Donald Yakel, MD: That is correct. I suspect that we'll be using this along with primary angioplasty for most heart attack victims, probably not too far in the future.

Host: For sure. And you've kind of covered this a little bit, but I want to go over how this therapy reduces heart failure conditions and really salvages the heart muscle.

Donald Yakel, MD: Sure. So when your artery blocks and there is a reduction or a complete cessation of blood flow to that area of heart muscle, the heart muscle starts to die from the inside out. The heart arteries sit on the outside of the heart and then penetrate into the heart muscle itself, much like you can kind of think of it as a, as a tree where the big arteries are the tree trunk and then the little arteries penetrate into the heart muscle and get smaller and smaller as they get deeper into the tissue. When the blood flow is cut off with a heart attack, the very small arteries on the very inside of the heart muscle, that area starts to die off first.

So once blood flow is restored, you've limited the amount of the size of the heart attack. So what happens with super saturated oxygen is that oxygen then is able to get to some of those heart muscle cells that are damaged, but not yet dead. And they're allowed to regenerate and they can continue to function.

And so it decreases the size of the heart attack. So your heart muscle function can either be completely restored, or at least it's not damaged as much as it would be if we did not have this therapy.

Host: Right, and folks maybe can avoid living, great to live of course, but living with a damaged heart muscle for the rest of their lives, there's certainly, obviously, inherent complications associated with that. We mentioned time and how it's of the essence. Maybe you can really stress, sort of underscore that time is, especially with this, SSO2 therapy, time is critical.

Donald Yakel, MD: Time is very critical. So much like with any body tissue, the longer that that tissue is without blood flow or without oxygen, the more of that tissue is going to die off. The studies have been clear that if you present to the emergency department in under two hours and get your heart artery opened back up, you may not suffer any damage at all.

And with this therapy up to three hours, with use of super saturated oxygen, you might not suffer any significant heart muscle damage. So it's very important to get into the emergency department as soon as possible, once you start having chest discomfort that you think might be a heart attack.

Host: Right. If you suspect that you're having a heart attack, call 9-1-1, get to the ED. Just want to finish up here today. This has been really educational. I told you I was going to benefit from your expertise and I have, and I'm sure listeners have as well. Finish up, hopefully the easiest one I'm going to give you today, but maybe the most important one when it comes to men and women and living longer, happy, healthier lives and avoiding maybe needing the SSO2 therapy, you know, how can we take care of ourselves best? And most importantly, how can we take care of our hearts?

Donald Yakel, MD: In America, it's super important to exercise and it's super important to watch your diet. And in America, our portions are probably the biggest thing that gets us. So portion control is super important. Keeping the weight off is super important. Some studies up to 85 percent of Americans are overweight to some degree, and this drives a lot of these metabolic disorders such as heart disease.

So it's really important, especially if you're sedentary and don't watch your diet much, to get into some kind of a, at least a walking program and to, it seems basic, but add in as much water and fruits and vegetables as you can and stay away from processed foods.

Host: Yeah, that's perfect. Well, I really appreciate your expertise today. Interesting to learn about new stuff that I don't know about, the TherOx SSO2 therapy and how patients are benefiting from this and saving heart muscles and it all sounds like good stuff. So thanks so much.

Donald Yakel, MD: Thanks for having us.

Host: That's Carle Cardiologist Dr. Donald Yakel, and for more information go to carle.org. If you found this podcast helpful, please share it on your social channels and check out the entire podcast library for additional topics of interest. I'm Scott Webb. Thanks for listening and join us next time on Let's Talk with Carle Health.