Wednesday, April 16, 2014

UK's advanced ventricular-assist device program for heart patients saves and improves lives

Two years ago, John Doty was diagnosed with walking pneumonia, and though antibiotics originally helped, the pneumonia came back with a vengeance, and he went to see a cardiologist. He found out his heart was severely weakened with an ejection fraction of less than 10 percent. "The ejection fraction is a measure of how effectively the heart can pump blood volume into the body, and in a healthy heart, that number falls between 50-65 percent," Allison Perry writes for the University of Kentucky, where Doty received a left ventricular assist device (LVAD) because his heart was so weak.

UK Chandler Hospital is Lexington's only hospital, and one of two in the state, that can perform emergency VAD procedures. "When Mr. Doty was transferred to UK, he was very sick, on a ventilator and requiring two medications to support his blood pressure," said Dr. Navin Rajagopala, a heart failure cardiologist at the UK Gill Heart Institute. "He was going into kidney and liver failure. It was clear that he needed an assist device as soon as possible before the damage to his body was irreversible."

VADs partially take the place of the function of a failing heart. They're more often used for the left ventricle, but some patients need the device for the right ventricle or even two devices to help both ventricles (BiVAD). Because VADs can help the heart rest and heal, some patients receive them after a heart attack or a surgery. People suffering from congestive heart failure might need a VAD for the rest of their lives.

A viral infection damaged Andy Baker's heart, and though he originally resisted the idea of a VAD, now he says he's "happy to keep the device and has no interest in getting a heart transplant," Perry writes. "I had mixed feelings about it," Baker said about getting the VAD, "but it's given me life again."

VAD treatment can save money for the both the patient and the hospital and allow at-home recovery. VADs can allow people to return to their normal lives, participating in many of the same activities they did previously. in about 5 to 10 percent of cases, the VAD even helps the heart to heal to the point that the device can be removed. That was the situation for Doty, whose device was removed 16 weeks after he got it. "I almost feel like I never had it," Doty said. "It wasn't that great of an imposition, considering that it was keeping you alive."

UK performs about 20 to 30 VAD procedures per year, and recently received its third straight biannual Certificate of Distinction from The Joint Commission, the leading accreditor of U.S. health-care organizations. That "shows just what an outstanding job our physicians, nurses and support staff are doing when it comes to treating patients who require these assist devices," said Dr. Maya Guglin, director of UK's Mechanical Assisted Circulation Program. (Read more)

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