Away go troubles, down the drain.

The heart, basically a pump with some complicated support systems, is prone to one of plumbing's banes -- clogged pipes. John B. Simpson, a cardiologist at Sequoia Hospital in Redwood City, Calif., has come up with what he hopes will prove the ultimate plumber's helper -- a device that shaves the fatty deposits of atherosclerosis from the inner walls of arteries.

The process is called transluminal atherectomy, and Simpson says it could one day provide an alternative to bypass surgery and balloon angioplasty.

In the last six months he has used the shaver to pare plaques from large arteries in the legs of six individuals, all of whom are now doing fine, he reports. If the leg-work continues to go well, says Simpson, a smaller shaver may be used on coronary arteries in a year.

The device looks like a cleverly modified, miniature Roto-Rooter and is snaked to the clogged area. The shaver itself is housed in a tube that has been partially cut away. When a tiny balloon on the opposite side of the tube is inflated, any fat deposits protruding from the arterial wall will bulge into the bore of the tube, where they can be neatly sliced off and packed into a storage area on the far side of the tube. Because the blade is encased in a tube, the shaver can't nick arterial walls, Simpson says.

Comments David P. Faxon of Boston University Medical Center, "The concept has some attractive features." Unlike balloon angioplasty, in which a balloon inflated in the artery tears, splits and stretches the plaque, the shaver removes the plaque and leaves a smooth wall, which may prevent the renarrowing that often occurs with angioplasty. It will also provide a way to monitor exactly what sort of material makes up the plaques, and whether drugs and other treatments change that.

But the device needs to prove itself. "If it has advantages," Faxon says, "we won't know until it's tested against other techniques."