Cardiac Device To Combat Congestive Heart Failure Puts Patient Back In Action

Cardiac Device To Combat Congestive Heart Failure Puts Patient Back In Action
Jose Vargas could not understand why completing the exercise portion of his Army training in 2002 was so difficult. He was exhausted after running, had lost his appetite and was increasingly lethargic. For the seemingly healthy 24-year-old, the symptoms were mysterious and troubling.
After several medical tests by military doctors, Vargas learned the surprising cause of his condition: congestive heart failure (CHF), a disease that usually affects older individuals. CHF occurs when the heart is unable to pump enough oxygen-rich blood to supply the body’s needs. CHF can result from a number of causes, weakening the heart muscle.

Vargas, who was put on medical retirement from the military and moved to Fort Meade, Md., was initially treated with heart medication. However, the drugs weren’t enough. Vargas was told he would eventually need a heart transplant. What Vargas didn’t know at the time was that his heart condition made him an excellent candidate for a unique medical device that could better prepare him for a new heart.

The device, called an LVAD, short for left ventricular assist device, is a long-term mechanical heart pump used to stabilize heart function until a heart transplant can be performed. Today, the retired army paratrooper no longer has a parachute strapped to his back. Instead, he wears a battery pack over his shoulder that powers the LVAD. It’s not an ideal solution, but it allows Vargas to have a more active lifestyle - within limits.

“I had no choice,” says Vargas. “It was either the implant or death.” Vargas received his device in December 2006 after being admitted to The Johns Hopkins Hospital for treatment of his idiopathic dilated cardiomyopathy; a disease of unknown cause characterized by dilation and impaired function of one or both heart ventricles. The device was inserted in Vargas’s chest and sewn to his heart’s left ventricle and aorta.

While the three-pound, titanium LVAD, is a life saver, it imposes some inconvencies. Showering requires covering the surgical incision site and sleeping must not be done on the stomach. “Sure it’s an inconvenience,” Vargas said. “But it’s better than being dead.” With blood now freely flowing to his organs, Vargas plans to celebrate his improved strength as a first-time participant in the American Heart Association’s Community Heart Walk in Baltimore on Sat., Oct. 27.

He will be walking with 20 members of his family, which includes Jodie, his wife whose birthday coincides with the day of the walk, and his 76 year-old grandfather, Marcial Vargas. Courtesy of friends, relatives and parents of the soccer team of 6-year-olds he coaches, Vargas has currently raised $1,300 in pledges.

Vargas’ doctors couldn’t be happier with his progress. Ilan Wittstein, Vargas’ cardiologist, an assistant professor in the Division of Cardiology at Johns Hopkins, says Vargas was gravely ill when first admitted to the hospital’s cardiac care unit. “I actually remember seeing him when he first came to Hopkins with heart problems. He was in bad shape, and there is no question that he would not have survived without the LVAD. Now it’s like he is a totally different person,” Wittstein says.

“He is a constant reminder that while heart disease can strike people of all ages, modern technology offers new hope and long term options for even the sickest patients. His story is truly remarkable.” The Johns Hopkins Hospital has done approximately 50 implants of the latest version of the LVAD in the last 12 months, according to John V. Conte, associate professor of surgery and director of heart and heart/lung transplantation at Johns Hopkins, and close to 200 implants of VADs since 2001.

According to a 2005 report from the American Heart Association, the LVAD has helped extend the average lifespan from three months to more than 10 months in 50 patients with severe heart failure. In some cases, patients have been kept alive for as long as five years. “In general, the LVAD is for people who need a heart transplant and whose expected survival is limited, but they have to be in good enough physical condition to handle the operation,” Conte said.

Vargas, who has been on the heart transplant list since April 2007, says he feels better than he has since 2003, the year he was diagnosed with congestive heart failure. “I wake up and I feel good.” Before the implant, he says, “I was very tired and wanted to sleep all the time.”

He has regained much of his strength and energy. He is enjoying coaching and his life to the fullest. “My doctors tell me to go out and enjoy myself,’ ” Vargas says. “I do it everyday and look forward to a long and healthy life with my family and friends.”

Source-John Hopkins

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