Implantable heart-assist pump:
Recovering at home while awaiting transplant
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Lancaster resident and folk guitarist Ray Miller
is singing a happier tune with his wife, Lynnette,
after receiving an implantable heart-assist pump
that made his recent heart transplant possible. |
Today Ray Miller strums his guitar and sings classic folk tunes with his wife Lynnette, just like the couple has done the past 38 years.
But four months earlier, this moment didn’t seem possible.
“Doctors weren’t sure if I was going to make it,” Ray says about the three weeks he spent in the Intensive Care Unit at Lancaster General Hospital following his third heart attack.
Ray was in advanced heart failure, and yet it seems the stars had aligned for the Lancaster musician. First, the damage was limited to the left ventricle of the heart, making him a candidate for an implantable ventricular assist device (VAD), a mechanical device known as the HeartMate™ that helps a weakened heart pump blood.
Second, he was being treated at the Lancaster General Heart Center, which is equipped to provide this advanced lifesaving option.
VAD in Lancaster
Lancaster General created its VAD program in July 2004, offering the external VAD as a “bridge to transplant” for patients in need of a new heart. With the external VAD, most patients remain hospitalized until the transplant.
Nine patients have received VADs at Lancaster General, says Susan Sample, MSN, CRNP, Lancaster General Director of Nursing, who also serves as the VAD coordinator.
Sample says a patient will be considered for a VAD if doctors determine the heart is not able to pump enough blood to the vital organs and other traditional therapies and surgery cannot help.
“In Ray’s case, we tried maximum medical therapy (medication), and we inserted an intraaortic balloon pump,” says Jeffrey T. Cope, MD, a surgeon with Cardiothoracic Surgeons of Lancaster, exclusive providers of heart surgery to the Lancaster General Heart Center. “Ray would go into heart failure every time we tried to wean the balloon pump. There was no other alternative except the VAD.”
Ray, 61, became the second patient at Lancaster General to receive the implantable VAD… a model that is more compact than the external device, allowing for more patient mobility. The only external part is a drive line that hooks to the body below the rib cage.
Awaiting a new heart can take months, and in some cases a year or more. So being able to recuperate at home with friends and family close by is a tremendous benefit. “The implantable VAD enabled Ray to go home, just like any other outpatient would,” Dr. Cope says.
Having a hospital like Lancaster General qualified to perform sophisticated cardiac procedures ensures that friends and family are nearby even when a hospital stay is necessary.
“We are able to perform ‘high risk’ surgery and still have a safety net,” Dr. Cope says. “If the heart is still not strong enough after bypass surgery, we can provide a VAD without having to transport the patient elsewhere for such a device. Not many community hospitals can do this. We are distinct in that regard.”
Destination Therapy
When transplant is not a viable option, the implantable VAD can serve as a permanent replacement, known as “destination therapy.”
“This provides an option for patients who are not transplant candidates, and it gives them a better quality of life,” Sample says.
“There are not nearly as many organ donors as there are people in need of a new heart,” Dr. Cope says. “The potential recipient population is several times higher. That is another role for the destination therapy VAD.”
Dr. Cope says Lancaster General is two VAD procedures away from qualifying as a certified destination therapy center by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), a distinction shared by very few community hospitals in the U.S.
Travelin’ for a Transplant
Ray was discharged a month after his heart attack, and three weeks after surgery. After being worked up for a heart transplant at University of Pennsylvania, a donor heart became available in a few short days. He and Lynnette traveled to Philadelphia for surgery on November 3.
Ten days later, Ray was home with a new heart and a new lease on life. It wasn’t long before he was picking up his guitar to duet with Lynnette or performing with his friends at the Lancaster County Folk Music and Fiddlers Society.
“Woody Guthrie’s song ‘I’ve Been Having Some Hard Travelin’,’ has become my theme song,” Ray says. “That’s how I’ve been feeling these past four months.”
“The best thing was that Ray’s heart attack happened close to home, and we could go to Lancaster General Hospital for treatment,” Lynnette says. A year earlier, Ray suffered a heart attack while in Ohio… an experience they were glad not to repeat.
“I’m here today because of the doctors, nurses and staff here at Lancaster General,” Ray says. “I feel very fortunate that they have the science that they do today.”
Ray calls his wife “my Florence Nightengale.” She kept a daily journal to keep track of Ray’s condition, and provide doctors with the most detailed information possible.
He now watches his diet closely and is doing more exercises to maintain his renewed health. “I want to do everything I can so that we can have another 38 years together,” Ray says.
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