The 10 Louisville-area heart failure patients who received implanted mechanical pumps through Norton Heart & Vascular Institute’s launch and certification of a ventricular assist device (VAD) program share that they’re experiencing a better quality of life or are hopeful that they will.
For many, the left ventricular assist device (LVAD) option offered an alternative to a heart transplant.
Ten patients received an LVAD through Norton Heart & Vascular Institute’s Advanced Heart Failure & Recovery Program during its first year of inception. The program also provides care for another 11 patients whose LVADs were implanted at UK HealthCare (UKHC) through a collaboration established in fall 2020 with UK Gill Heart & Vascular Institute in Lexington, Kentucky
“For these patients, quality of life was impacted. Because their heart is not working properly, it is causing their breathing to be labored; they have severe swelling in the legs and feet and are just exhausted. Their everyday activities were limited — even the basics of grocery shopping, doing their hobbies or caring for loved ones,” said cardiologist Kelly C. McCants, M.D., executive medical director of the Advanced Heart Failure & Recovery Program and executive director of the Institute for Health Equity, a Part of Norton Healthcare.
Ventricular assist device pumps most commonly are used to treat patients with left-sided heart failure Patients eligible for LVAD consideration have reached the fourth stage of heart failure — severe limitations even while resting.
Building the team with the expertise needed to launch a certified VAD program has been a huge undertaking, especially during the COVID-19 pandemic, according to Dr. McCants. The program has been accredited by DNV Healthcare and the Centers for Medicare & Medicaid Services.
“We have a dedicated multidisciplinary LVAD team led by two outstanding cardiothoracic surgeons, Steven W. Etoch, M.D., and David H. Rosenbaum, M.D., in addition to a host of advanced heart failure cardiology providers and staff who really are the backbone of this program,” Dr. McCants said.
Physicians, advanced practice providers, nurse VAD coordinators, pharmacists, nutritionists, therapists, social workers and others provide crucial support to make a VAD program successful. Moreover, everyone who may interact with a patient during the hospital stay must have proper education and training in case an emergency arises.
Once considered solely a way to keep patients alive until a donor heart becomes available, a VAD is now often an alternative to a heart transplant. Two-year survival rates approach 90%. The devices are readily available, while transplantable donor organs are very limited.
The VAD is implanted during an open heart procedure, which typically lasts four hours and requires a hospital stay of at least 14 days. The 10 Norton Heart & Vascular Institute VAD patients in 2021 had an average hospital stay shorter than the national benchmark.
Following surgery, specially trained cardiac nurses and VAD coordinators monitor the patient, focusing on safety and education of the family and caregivers. Then the patient can go home and start resuming daily activities. Before and after surgery, advanced heart failure cardiologists including Bassel Alkhalil, M.D., and Srikanth Seethala, M.D., provide weekly and monthly care.
“Our mission is to assist these patients along their heart failure journey, whether it is medical management of heart failure, providing mechanical circulatory support, or collaborating with established heart transplant programs like the University of Kentucky. Our goal is to provide excellent care close to home as we continue to build on our outstanding program,” Dr. McCants said.