Tuesday, January 29, 2013
The newest generation of implantable heart pumps are keeping many patients alive while they wait for a heart transplant.
SAN DIEGO For people under 65 with end-stage heart disease, a heart transplant can mean the difference between life and death.
But there aren’t nearly enough donated hearts to go around. As a result, thousands of Americans are on a waiting list, including 30 people in San Diego.
Paul Conway works hard to stay in shape. He pumps iron at least three times a week.
In his living room in Chula Vista, Conway lifts barbells very slowly and deliberately.
"‘Cause if you jerk it, or you yank it, and use momentum, momentum doesn’t build muscle," Conway said. "I try to make the muscle do all the work."
Back in his prime, Conway was a competitive body builder. He won a lot of competitions.
"Right now, I’ll never look like I did when I was 22 years old, when I won the Border State," Conway said, as he glanced at his trophies. "That’s a long time ago. I’m glad I did it, I’m glad I won it. But now all I can do is be the best 53-year-old I can be."
That’s not easy, because Conway has end-state heart disease. So what’s keeping him alive?
A heart pump called a left ventricular-assist device, or LVAD, for short. The device is implanted in Conway’s chest.
It’s powered by special batteries that Conway keeps in a fanny pack.
"There’s two batteries. You can pop ‘em out," he said, as he took one of the batteries out of the controller. "And within a minute or so, it’s gonna start beeping. That’s basically telling me, you better put your battery back in."
When Conway goes to sleep at night, he plugs the device into the wall.
Conway said after he first complained of shortness of breath in 2005, doctors discovered he had a blocked artery. So they put in a stent. His heart problems continued, and Conway had to have more stents put in.
"In 2008, one of those 10 stents had two blood clots go into it," he explained. "They blocked the major artery, I believe, I forget the technical name for it, but they call it the widow maker, I think it is. And it hard a heart attack, my body, and it destroyed probably 50 percent of my heart."
Conway’s wife Grace said after that, he grew weaker and weaker. She said he couldn’t even walk up the stairs.
"He couldn’t leave the house," Grace Conway recalled. "He couldn’t go out and get our mail. He was short of breath, and we couldn’t do hardly anything. And it was scary, it was very scary. And the kids had asked me at one point, are we still gonna have a dad?"
There aren’t many options for people who have terminal heart failure, explains Dr. Walter Dembitsky, the director of cardiac surgery at San Diego's Sharp Memorial Hospital.
"To either go to the hospice care system, or to have a heart transplant, or to have one of these pumps," Dembitsky said.
The heart surgeon said the LVAD pump is becoming a popular alternative to heart transplants. That’s because donated hearts are in such short supply.
The non-profit group Lifesharing oversees organ donations in San Diego and Imperial Counties.
Executive Director Lisa Stocks said it takes a very special set of circumstances for someone to become a heart donor.
“The person has to die in a hospital, with a brain injury, while their heart is still beating," she said. "They have to be of a certain age while the heart is still viable. And their family has to consent for donation, or they have to be on the registry to donate.”
Dembitsky said he’s had patients who’ve lived for years with an LVAD, including one man who’s had the pump for more than a decade.
"It is a proven fact that this is good for you if you have terminal heart failure. It’s good for your survival, it’s good for your quality of life," Dembitsky pointed out.
But LVADs aren’t perfect. They increase the risk of stroke. And they’re not appropriate for every patient with advanced heart disease.
Conway has been on the waiting list for a heart transplant for more than two years. In the meantime, he’s learned to live with his LVAD. And so have his daughters: 10-year-old Ashley and 13-year-old Krista.
"It’s kind of sad, but it’s mostly fun, because he can still do most things, like he still takes us places like, he still goes to Disneyland with us, and he can go on the roller coasters, some of them, still," Ashley explained.
"I guess it’s just cool, ‘cause he’s like all robot," said Krista, smiling.
Conway said until he gets his heart transplant, he’ll hang tough with his LVAD.
"I mean I know it’s here, and I know it can be aggravating," Conway admitted. "But every time I look at it, if I do get aggravated at it, I say it saved my life. It gave me three more Christmases, three more New Years, three more Halloweens with my daughters and my wife. So, how could you complain about that?"