FORUM HEALTH State-of-art device saves a life

The device gives dying heart patients a chance at life.
By WILLIAM K. ALCORN
VINDICATOR STAFF WRITER
WARREN -- The confluence of foresight, skilled heart surgeons and Forum Health's willingness to invest in technology saved a Warren man's life and made medical history in Trumbull County last week at Forum Health Trumbull Memorial Hospital.
The story began two years ago when Forum Health shelled out $600,000 for two ABIOMED BVS5000 ventricular assist devices, one for Northside Medical Center in Youngstown and one for TMH.
The machines are connected to a patient's heart via tubes and help severely damaged hearts pump blood to other vital organs.
"We were seeing more heart patients and more complicated cases, and we made the device available for both hospitals," said Dr. Pyongsoo D. Yoon, director of cardiovascular surgery for the Heart Hospital at Forum Health.
However, since then, both machines have sat on the shelf waiting for the right set of circumstances.
Massive heart attack
Then, on Feb. 22, a patient, whom the hospital would not identify because of privacy laws, suffered a massive heart attack, his second, and arrived at the TMH emergency department.
The patient, a relatively young man, was taken to the cardiac catheterization lab, where an intra-aortic balloon device was inserted to open his arteries and help maintain his blood pressure, which was very low, said Dr. Fadi Naddour.
However, the patient had extensive blockage in all arteries and his heart was functioning at less than 10 percent capacity, said Dr. Naddour, chief of interventional cardiology at TMH.
"He had a 90 percent chance of dying, and we knew he was not a good candidate for normal treatments," said Dr. Naddour, who called thoracic surgery within an hour of the patient's arrival.
The patient was taken directly to surgery, and a quadruple bypass operation was performed by Dr. John C. Cardone, a cardiothoracic surgeon at TMH.
The patient sustained himself for about 24 hours after bypass surgery, but he didn't have enough heart muscle to survive and took a turn for the worse, Dr. Cardone said.
Decided to use device
At that point, the cardiac surgery team made the decision to use the ventricular assist device as a last resort to save the patient's life.
"We worked under the direction of a transplant center, which told us to forge ahead," Dr. Cardone said.
Because his heart was not working, and other vital organs were in danger of being damaged, there was not time to transport the patient elsewhere for treatment.
Though none of the surgical team had done the procedure before, they went ahead, and the improvement in the patient was "dramatic."
"Once we put the device in, which took about 90 minutes, the other organs began functioning again," Dr. Yoon said.
His lungs cleared of fluid and his kidneys began making urine, Dr. Naddour said.
The patient is recovering at a heart transplant center, where he was transported some 36 hours after arriving at TMH.
The ventricular assist device used at TMH, effective for up to two weeks, saved the patient's life and gave him a "bridge to recovery" or a "bridge to a transplant," Dr. Yoon said.
Praise for physicians
There is a sense of accomplishment in knowing a patient has a chance to live, which he would not have had without the device, said Dr. Cardone.
It took courage on the part of the cardiologist to call the surgeons, and of the surgeons to perform the procedure, said Kevin M. Spiegel, chief operating officer at TMH.
"The availability of this technology in the community is extremely beneficial. In the case of this patient, use of the ventricular assist device bought him some time to recover or get other treatment," Dr. Yoon said.