Baylor Innovations - BUMC Summer 2010

Change Of Heart

Dawn Weinberger 0000-00-00 00:00:00

LVAD keeps a patient's heart beating. LESS THAN THREE YEARS AGO, CHAD WHEELER was diagnosed with congestive heart failure. He was only 36. “I was at work one day and I started getting winded,” he says. “I would walk across the yard, and I had to sit down.” His physician urged him to see a cardiologist. Before he could schedule an appointment, his shortness of breath became more troublesome. Concerned, his wife took him to the emergency room at Baylor University Medical Center at Dallas. He had dilated cardiomyopathy and it was progressing. “The condition weakens and enlarges the heart, preventing it from efficiently pumping blood,” says Shelley A. Hall, M.D., cardiologist and medical director of the heart transplant program at Baylor Dallas. His best bet was a heart transplant.He was placed on the transplant list, and started on what would ultimately be a two-year wait for a new heart. While he waited, Wheeler Needed a treatment protocol that would keep his heart in the best possible condition. STEPS TO A NEW HEART The first step, for Wheeler and many patients like him, was oral medical therapy – typically a combination of beta-blockers and ACE inhibitors. The regimen worked for about five months. Then physicians on the medical staff switched him to intravenous medication, which stimulates pumping and keeps people stable. However, the effectiveness of the intravenous (IV) doesn’t last forever. “Some patients can do well on the IV for a year. Then they get used to it and don’t respond to the maximum dose,” says Dr. Hall. That’s about how long it worked for Wheeler. “It made me feel better, but as time wore on my heart got weaker,” Wheeler says. “That is when I transitioned to an LVAD.” CROSSING THE BRIDGE An LVAD, or left ventricle assist device, is a mechanical device that takes over for a failing left ventricle. In Wheeler’s case, it served as a short-term solution until a heart was available For transplantation, but the U.S. Food and Drug Administration recently approved a newer version for use as “destination therapy” that can serve as a permanent solution for patients who are not candidates for transplant. Though the device lasts up to seven years, Wheeler had it for just 10 months before he received a new heart on October 26, 2009.He felt much better on the LVAD, even taking a vacation at one point – an outcome that mirrors the results of a 2009 study from the University of Michigan, which found that LVAD patients enjoy “improved functional status and quality of life.” Post-transplant, Wheeler is working hard to keep his new heart in good shape, and his recovery is going well.

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