Posts Tagged ‘Heart Failure’

Heart Transplant Patient Success Story

Dr. Vega, Emory Heart and VascularHerbert Grable was diagnosed in 2000 with congestive heart failure. When he was diagnosed, it came as a shock and he was scared. He didn’t know what caused his heart to fail and he didn’t know what heart failure treatments were available for him. He was very grateful to have the Emory Heart & Vascular Center near his home, as it offered a unique treatment for patients who are not candidates or can’t get a heart transplant right away – called Ventricular Assist Devices (VAD).

As we have discussed in previous blogs, a VAD is a mechanical device that is implanted in the heart. This pump takes over the function for the ventricle and circulates blood to the rest of the body. The goal of a VAD is to improve a patient’s survival and quality of life while they wait for a transplant (if they are a candidate for a transplant). The number of heart failure patients is tremendous, and with the number of transplants regulated per year at around 2,500 the VAD is another option for non-transplantable candidates as well.

After receiving the VAD, Herbert smiled and joked that he felt like himself again. His wife commented that the she got the “old Herbert back.” After eight months with the VAD, Herbert was again upgraded to the transplant list. One week later, he received the call  from Emory Transplant Center that a heart was available for him. Before transplant, Herbert was scared but he had faith in Emory and was determined that everything would work out. His wife was hopeful and optimistic that Herbert would be with her for many more years and would possibly see some grand kids one day.

Transplants are complex procedures. Emory transplant physicians are experts in their field and aware of all possible nuances that occur with each individual transplant patient. Should an unusual complication arise during a transplant experience, Emory has the skill to reach the most optimal outcome for a patient.

After Herbert received the heart transplant, he was able to live a normal lifestyle and do everything he always did before he was diagnosed with heart failure. He sums up his care “Emory is not just hospital, they care about the patient as well. I am so glad to have a place like Emory to treat me for this condition.”

For more information about heart transplant after the VAD procedure, watch this video:

About Dr. Vega

Dr. David Vega is a cardiothoracic surgeon at the Emory Heart & Vascular Center and the Director of Emory’s Heart Transplant program at Emory University Hospital. He implanted Georgia’s first dual pump ventricular assist device (VAD) in 1999 to serve as a bridge to heart transplantation, a procedure that initiated Emory’s ongoing national position at the forefront of the use of mechanical circulatory assist devices. In 2006, he implanted the state’s first VAD as a form of destination therapy for individuals who are ineligible for or are unwilling to undergo a heart transplant, and in 2007 he implanted an even smaller VAD for the same purpose that featured an automatic speed control mode designed to regulate pumping activity based on different levels of patient or cardiac activity.

Heart Failure – What Should I Know?

Sonjoy Laskar MD

A heart failure diagnosis may sound frightening, but with the right treatment, heart failure can be controlled. Once you are on a stable medical regimen, you can often return to a full and enjoyable life. With the recent passing of actress and icon, Elizabeth Taylor, we would like to take some time to provide some information about congestive heart failure.

Facts:

  • Congestive Heart Failure (CHF) affects nearly 5 million Americans
  • Approximately 550,000 new cases are diagnosed in the U.S. each year.
  • Congestive heart failure affects people of all ages, from children and young adults to the middle-aged and the elderly.
  • Almost 1.4 million persons with CHF are under 60 years of age.
  • CHF is present in 2 percent of persons age 40 to 59.
  • More than 5 percent of persons age 60 to 69 have CHF.
  • CHF annual incidence approaches 10 per 1,000 population after 65 years of age.
  • The incidence of CHF is equally frequent in men and women, and African-Americans are 1.5 times more likely to develop heart failure than Caucasians.
  • More than half of those who develop CHF die within 5 years of diagnosis.

Symptoms:

  • Shortness of breath with little exertion
  • Feeling weak or tired after little activity or exertion
  • Difficulty sleeping due to breathing problems
  • A new or different cough, especially while lying flat
  • A swollen and/or tender abdomen
  • Loss of appetite
  • Increased urination at night
  • Swelling of the feet and legs

Early diagnosis and treatment for heart failure is very important. Heart failure is a chronic condition that may follow a varied and unpredictable course. If you are experiencing heart failure symptoms, you should see your cardiologist. If you have been diagnosed with heart failure, adhering to the treatment plan designed by your doctors and nurses can help you navigate this challenge. Your symptoms can be controlled with proper medical care.

About Sonjoy Laskar, MD:
Dr. Laskar joined Emory Healthcare in 2005 and has devoted his career to providing direct care to patients with heart failure, heart transplantation and ventricular assist devices, as well as to teaching residents and fellows. He is an active researcher in the areas of echocardiography and ventricular assist devices as destination therapy, and is a member of the American College of Cardiology, Heart Failure Society of America and the International Society of Heart and Lung Transplantation

Understanding Heart Failure

Heart failure, put simply, is a condition in which the heart doesn’t pump as well as it should. Nearly 5 million Americans currently suffer from it, and approximately 550,000 new cases are diagnosed every year. So, why does it occur? Unfortunately there’s no straightforward answer to this question—heart failure can stem from a number of factors, including diabetes, obesity, lung disease, coronary artery disease, heart valve disease, congenital heart disease, irregular heartbeats, long standing high blood pressure and more.

A normal, healthy heart pumps plenty of oxygen-rich blood out of the heart and into the system, nourishing the entire body. Signs of heart failure enter the equation when the heart doesn’t eject blood efficiently enough to meet these oxygen demands. The condition can occur suddenly, or it may advance slowly over time.

In order to understand heart failure, we must first examine the two main types: systolic and diastolic. With every heartbeat, the heart contracts and relaxes. Systolic heart failure (the most common type) occurs when the heart doesn’t contract properly due to weakness in the heart muscle, which causes the ventricles to stretch. In the case of diastolic heart failure the heart contracts well, but is unable to relax properly, causing the muscles to thicken and harden.

Both types of heart failure render the heart unable to properly fill with blood, which can cause the blood to accumulate into the lungs, hands, abdomen, legs and feet. This “backing up” of fluid is often referred to as “congestion”, or congestive heart failure.

Symptoms of heart failure include:

–       shortness of breath with little exertion

–       weakness or fatigue with little exertion

–       difficulty sleeping

–       unfamiliar coughing

–       swollen/tender abdomen

–       loss of appetite

–       increased urination at night

–       swelling of feet and legs

The importance of early diagnosis and treatment of this condition can’t be overstated. Further, it’s critical to identify the underlying cause of heart failure in order to determine the best course of treatment, which can range from medications, to device implants to surgeries, depending on the severity of the condition.

We strongly encourage patients to take an active role in controlling their symptoms by taking their medication regularly, monitoring their weight, heart rate and blood pressure, following diet and exercise recommendations and managing stress.

Heart failure is a chronic, progressive condition; however, patients who proactively monitor their key symptoms and adhere to their treatment plans can drastically improve their outlook for the future.

Have you or someone you love been affected by heart failure? If so, please feel free to share your thoughts or questions with me in the comments.

Exploring VAD Therapy

In this video, I go into more detail about VAD therapy and show you an actual VAD device:

Ventricular Assist Devices: Hope for the Broken-Hearted

HeartMate II® LVAD; reprinted with permission from Thoratec Corporation

Many of you are aware of the benefits of heart transplant in patients with advanced heart failure; however, another form of therapy has been quietly emerging as a viable option for patients suffering from this condition.

A ventricular assist device (VAD) is a battery-operated mechanical pump that helps a weakened heart pump blood into the body. Essentially, it takes over the pumping action of the heart and drives blood into the aorta (the large artery that extends from the left ventricle of the heart and into the abdomen) and throughout the body. The device resides both inside and outside of the body, and is operated by an electric motor powered by a battery pack. The controller and batteries are typically worn over the shoulder or around the waist.

In most cases, VADs offer a short-term solution for patients awaiting a suitable donor for a heart transplant, particularly if their medical therapy has failed or if they’ve been hospitalized with end-stage heart failure. According to the United Network for Organ Sharing, over 2,900 Americans are currently awaiting a heart transplant (43 of which are in Georgia).

However, in some cases patients turn to VADs as an alternative to a heart transplant. We refer to this as ‘destination therapy’, meaning that the LVAD serves as a permanent solution for patients with advanced heart failure. Patients who are not heart transplant candidates but who have severe heart failure often pursue this course of treatment.

Ventricular Assist Devices support the left ventricle (LVAD), the right ventricle (RVAD) or both simultaneously (biventricular, or BiVAD). LVADs are used most commonly, and have been in existence for over twenty-five years.

A recent study comparing a new generation LVAD to an older model showed a marked improvement in survival at 2 years (58% vs 25%). In addition, patients reported an improved quality of life. As a result the FDA approved the Heartmate II as destination therapy for patients with end-stage heart failure.

Despite the severity of their illnesses, 70-80% of LVAD patients survive to transplantation.

There are several different types of LVADs, and I’ll go into more detail about specific devices and technology that the Emory Heart and Vascular Center utilizes in a later post. You’ll also hear from two very special patients who have been kind enough to share their stories with us.

Do you have any questions or thoughts about VAD technology or heart conditions in general? If so, please share them with me in the comments.

About Sonjoy Laskar, MD:

Dr. Laskar joined Emory Healthcare in 2005 and has devoted his career to providing direct care to patients with heart failure, heart transplantation and ventricular assist devices, as well as to teaching residents and fellows. He is an active researcher in the areas of echocardiography and ventricular assist devices as destination therapy, and is a member of the American College of Cardiology, Heart Failure Society of America and the International Society of Heart and Lung Transplantation.