S T A N F O R D M E D I C I N E

Volume 18 Number 2 Fall 2001
index

A Heart Helper:
Many heart failure patients
receive LVAD imjplants -
but children and many women
are too small to host
these devices. That's why
they support their hearts
with an external pump
such as the Thoratec
pictured here.

Demanding saviors
by Charles Clawson
LVADs offer hope - but note without hassle


Thomas Barron, a 64-year-old mortgage company owner from Novato, Calif., suffered a heart attack last fall. After being transferred between several hospitals and undergoing a failed bypass operation, Barron, unconscious and near death, was finally shuttled to Stanford Hospital, where surgeons gave him an LVAD, a mechanical pump to help his heart do its job ( see main story).

“It saved my life,” he says. “I’m lucky to be here.” But wearing the device was a challenge — to put it mildly, Barron adds.

Social worker Mary Burge, who works with Stanford University Medical Center’s heart transplant patients, elaborates: “You’re tethered to a power source, either to a wall outlet or batteries that are pretty heavy to carry around. People carry them in a backpack or in a vest that looks either like a fishing vest or terrorist gear, depending on your perspective,” she says.

“The batteries are only good for a couple hours, so you have to be sure to always have charged batteries available. Then there’s all the care of the device, the need to clean the sites where tubes or wires pass through your skin and to make sure that everything’s running smoothly. And at night you have to plug yourself into a bedside monitor. We’ve had some people cut it fairly close with their batteries.

“An LVAD operator is on call 24 hours a day,” she adds.

The device can cause a stir when worn in public because it emits a distinct ticking sound, like a loud grandfather clock. One patient compared the sound to the clip-clop of horse hooves on cobblestone, another to “the ticking clock that the crocodile swallowed in Peter Pan.”

Children tend to be curious about the sound and ask “Why are you ticking?” Adults are more likely to look at the LVAD patient with suspicion, says Burge. “One patient went to church and the minister asked him if there was some way he could quiet the sound by muffling it with a pillow.”

Barron found the vest cumbersome and elected to haul the battery pack and controller in a shoulder bag. Together they weighed about six pounds. “I was kind of beat up and tired by the time I got to work, because I carried about five extra batteries with me in a ‘roll-on’ suitcase, which I had to load into the car. Then I’d drive myself to work, which I wasn’t supposed to do.

“When they took the LVAD out of me, Julie [Shinn, Stanford Hospital clinical nursing specialist] told me it was a good mechanical test because I was really hard on it. I dropped it a couple times. One time I set the battery pack and controller down on the sink and as I reached over for something, I saw it out of the corner of my eye as it tipped off the counter, like slow motion, falling to the floor. That hurt!”

Clyde Jorgensen, a 59-year-old retired computer network designer from San Francisco, had developed end-stage heart failure in early 1996 and was placed on the Novacor pump from April 1996 until his transplant in November that year.

“In April my wife was told that if anyone wanted to say good-bye to me, now was the time. I hadn’t been able to get out of bed for two or three weeks. My blood supply had been low for a while, so I had minor damage to my organs — liver, kidneys — from lack of blood flow.

“I was really debilitated after the surgery to implant the LVAD — after a week or so I had to learn how to walk again. I spent the next couple of weeks walking around the hospital. It’s hard for me to describe how difficult it is to get through something like that for seven months.

“But it allowed me to get strong enough so that the day I got the transplant I was able to stand up. The device saved my life for long enough to allow me to not only get the same blood-type transplant but a very close tissue type, so I've never had any rejections. I'm very thankful for that.”

SM

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Copyright © 2001, Stanford University School of Medicine. All rights reserved.