LVAD Bridge to Heart Transplant After Chemo


SAN DIEGO, Calif. (Ivanhoe Newswire) — Scott Fitzgerald survived lymphoma in 1999. Thirteen years later, his doctors told him the chemotherapy that kept him alive was now causing his heart to fail. He wasn’t healthy enough for a heart transplant, so his medical team turned to a left ventricular assist device, or LVAD.

Scott’s dream of becoming a chef didn’t look possible just a few years ago. He developed cardiomyopathy despite taking medication to regulate his heart rate and control swelling.

“I was having problems breathing when I’d walk. I could go 20 feet and I’d start breathing hard. It would be difficult,” Scott told Ivanhoe.

Scott was too sick for a heart transplant, so his doctors turned to an LVAD to keep him alive.

Tom Heywood, MD, Scripps Clinic, Scripps Memorial Hospital La Jolla, said, “We put in a mechanical heart, which was about a five-ounce pump that we put in the heart to help unload the heart and pump blood into the aorta.”

LVAD patients wear an external battery and control unit, but the current system is smaller and more efficient than previous models. A national center for biotechnology information study shows the LVAD more than doubled one year survival rates.

Scott shared, “I had more energy. It wasn’t 100 percent. It was probably 75 percent better than what it was. I had my life back. The LVAD made a huge difference.”

With the help of the LVAD and a gastric sleeve, Scott lost 65 pounds and got his heart transplant.

Dr. Heywood stated, “When he got the transplant, he was quite healthy because of the pump. He recovered.”

Dr. Heywood has a message for other heart patients… “We want to let people know that there’s a large amount of hope, and that we can treat heart failure very effectively and in fact, cure it in many cases.”

Despite the road map of scars on his chest, Scott says life gets better every day.

The LVAD does come with risks like stroke, infection, and malfunction, and it is expensive at about 85,000 dollars. Cancer drugs causing heart problems later in patients’ lives is a growing concern. Scripps Health is developing a cardio-oncology clinic. Patients could get echocardiograms and blood tests to monitor their heart function during or after chemo.

Contributors to this news report include: Wendy Chioji, Producer; Bruce Maniscalco, Videographer; and Roque Correa, Editor.   

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REPORT #2547  


BACKGROUND: About 610,000 people die of heart disease in the United States every year. It is the leading cause of death for both men and women. More than half of the deaths due to heart disease in 2009 were in men. The most common type of heart disease in the United States is coronary artery disease, which affects the blood flow to the heart, and results in over 370,000 deaths annually. Decreased blood flow can cause a heart attack. Several health conditions, your lifestyle, and your age and family history can increase your risk for heart disease. These are called risk factors. About half of all Americans, 47 percent, have at least one of the three key risk factors for heart disease: high blood pressure, high cholesterol, and smoking. Some of the risk factors for heart disease cannot be controlled, such as your age or family history. But, you can take steps to lower your risk by changing the factors you can control. Every year about 735,000 Americans have a heart attack. Of these, 525,000 are a first heart attack and 210,000 happen in people who have already had a heart attack.

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HEART DISEASE AND LVAD: The left ventricular assist device, LVAD or VAD, is a kind of mechanical heart pump. It’s placed inside a person’s chest, where it helps the heart pump oxygen-rich blood throughout the body. Unlike an artificial heart, the LVAD doesn’t replace the heart. It just helps it do its job. An LVAD restores normal blood flow to a person whose heart has been weakened by heart disease. This relieves symptoms such as being constantly tired or short of breath. And sometimes it lets the heart recover normal function by giving it a chance to rest. This can mean the difference between life and death for a person whose heart needs a rest after open-heart surgery or is too weak to effectively pump on its own or who is waiting for a heart transplant. A permanent LVAD is currently being used in some terminally ill patients whose condition makes them ineligible for heart transplantation. This is also called destination therapy. In studies, therapy with the permanent LVAD device doubled the one-year survival rate of patients with end-stage heart failure as compared with drug treatment alone. However, there were some risks, including infection, stroke, and bleeding.


LVAD COULD IMPROVE QUALITY OF LIFE FOR ELDERLY: In studying whether frail patients might benefit from surgery to treat heart failure, researchers looked at whether the left ventricular assist device (LVAD) surgery could improve measures of frailty and quality of life. They found that for some patients, it did, as early as three months after surgery. Gordon Reeves, MD, Associate Professor of Cardiology at the Sydney Kimmel Medical College at Jefferson University, said, “Surgery can carry greater risks for older, frail individuals, but we wanted to test whether the LVAD could reverse frailty and improve quality of life in these higher risk patients.” He continued, “Importantly, this study shows that frailty is modifiable, it can get better with interventions like the LVAD.” The researchers found that there was a significant improvement in frailty with LVAD surgery and that this continued through six months of observation after the surgery. However, despite this improvement, about half of patients remained frail. “Although these results show that the LVAD procedure can decrease measures of frailty in some patients, we know that it does not completely reverse it,” said Dr. Reeves.


* Contact:  Tom Heywood, MD                                                    Keith Darce, Public Relations Manager                 

(858) 678-7121