Transplant Center

Cardiothoracic surgeon implants LVAD and gives former hospice patient a new lease on life

Selzman

During an October clinic visit, Tina Legarreta bantered back and forth with Erin Davis, R.N., Ventricular Assist Device (VAD) coordinator, and Craig H. Selzman, M.D., professor of surgery. The appointment’s lighthearted tone made it difficult to imagine just two months prior this vibrant woman was in hospice care and given only hours to live.

Legarreta, a 69-year-old Idaho native, was diagnosed with congestive heart failure 12 years ago and told that her heart was operating at 25 percent. She received a defibrillator and pacemaker, but the diagnosis didn’t slow her down. In fact, last year, she and her husband, Julian, traveled to Spain to visit family.

Upon returning to the states, however, things began to go downhill. “I was in and out of hospitals nine different times within four months,” Tina recalls. She underwent several surgeries: one in Utah to repair her heart’s mitral valve and another in Idaho to remove her gall bladder. It was during the latter surgery that she went into cardiac arrest. She spent 12 days in a Boise hospital’s critical care unit before physicians placed her on hospice care, telling her family she had eight to 24 hours to live.

Everyone waited anxiously. But Legarreta hung on. Three days later, against all medical odds, her organs started working again. Her cardiologist knew about a clinical trial at University Hospital, which would allow her to receive a new generation left ventricular assist device (LVAD), a cardiac assist system designed as a permanent alternative to heart transplant for patients suffering from heart failure. He immediately contacted University Health Care cardiologists E. Michael Gilbert, M.D., professor of internal medicine, and Feras M. Bader, M.D., assistant professor of internal medicine, to arrange for Legarreta’s transfer to University Hospital.

On Aug. 25, Selzman, surgical director of the Cardiac Mechanical Support and Heart Transplant program and principal investigator for the clinical trial, implanted the VentrAssist LVAD into Legarreta. Selzman says University Health Care Cardiothoracic Surgery remains the only program in the region actively studying novel devices to support the failing heart. The University is testing the VentrAssist in two different trials, one to see if it works as a bridge to transplant and the other to check it out as a destination therapy for patients, such as Legarreta, who do not qualify for a heart transplant. “Patients can expect to have a markedly improved quality and length of life following the surgery,” says Selzman.

For the Legarretas, it wasn’t a difficult decision. Tina has a family history of heart disease: both of her parents and her son died of heart conditions. When the advanced heart failure team of doctors, coordinators, and nurses explained the procedure to her, Legarreta responded without hesitation, “Let’s do it.”

Legarreta is grateful for her new lease on life. She can now go out to eat, take walks, go to the movies, and travel. “I’ve been lucky because I’m still  here.” While there are restrictions on her activities, such as no swimming or running, she says that comes with age anyway. “I can still live a full life. That’s the remarkable thing about it.”

Legarreta’s new best friend is a controller and battery pack, connected through a small line to the implanted LVAD, that she always carries with her. When people ask her what’s in the mysterious shoulder bag, she proudly replies, “It’s my heart.”

Majority of Heart Failure Patients Must Opt for Alternative Treatments

According to the American Heart Association, heart failure affects about 5 million Americans, with more than half a million new cases diagnosed each year. With the population of heart failure patients increasing and the number of heart transplants remaining around 2,000 a year, a majority of patients must opt for alternative treatments, such as an LVAD. The goal is to make LVADs smaller, longer-lasting, and more userfriendly.

The VentrAssist LVAD differs from earlier cardiac assist devices because of its small size—it weighs only 10 ounces and has a diameter of 2.5 inches—making it suitable to be implanted in both children and adults. It also has a single moving part that may not wear out as quickly.

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