For Qiaorong “Joey” Wang and Sidney Carey, it was the worst of times. They each suffered advanced heart failure and could have died. Now, thanks to the physicians and staff at California Pacific Medical Center’s Heart and Vascular Center – including the Heart Failure and Transplant Program – both patients are looking forward to the best of times.
Wang thought she had the flu, but when a doctor at Chinese Hospital examined her, he discovered she had acute myocarditis – an inflammation of the heart muscle often caused by a viral infection. The doctor transferred her to California Pacific, under the care of Ernest Haeusslein, M.D., a cardiologist specializing in heart failure.
Wang was transferred to the Cardiac Care Unit (CCU), where the 36-year-old went into cardiac arrest. The CCU staff revived her with cardiopulmonary resuscitation (CPR), but her heart stopped again. This time, Haeusslein called in Surgical Director of the Heart Transplant Program G. James Avery, M.D., and cardiothoracic surgeon Glen Egrie, M.D.
The CCU staff continued to perform CPR for an incredible 65 minutes, taking turns while Wang was wheeled into the operating room and while Avery put her on cardiopulmonary bypass. The doctors then inserted a temporary ventricular assist device (VAD) to take over the pumping function of the heart.
“The CentriMag® VAD is a good ‘quick fix’ because it can be inserted rapidly,” explains Avery. “But it is not a long-term solution.”
A few days later, Avery removed the CentriMag and replaced it with a HeartMate II® LVAD (left ventricular assist device). While the LVAD is often used as a bridge to heart transplant, Avery hopes that in Wang’s case it will be simply a bridge to recovery and can ultimately be removed.
“Joey has youth on her side, so it shouldn’t take long for her to regain her strength,” he says. “If her heart recovers sufficiently, we’ll remove the device, and she won’t need a transplant.”
In March 2008, Carey had all the symptoms of advanced heart failure, yet he ignored them. “I had shortness of breath and couldn’t walk halfway across the room,” he says. “I couldn’t sleep. I had no appetite. I was having night sweats. I basically spent my life sitting in a chair, but I didn’t go to a doctor for months. Then I swelled up like a balloon.”
Carey’s primary care physician referred him to California Pacific, where Haeusslein immediately recognized the symptoms of congestive heart failure and admitted him to the hospital. Haeusslein ordered diuretics to alleviate Carey’s swelling and sent him to California Pacific’s nationally certified Echocardiography Lab for an evaluation. The echocardiogram showed Carey’s ejection fraction (EF) – a measure of the heart’s pumping ability – was only 10 percent. The normal EF ranges from approximately 50 to 70 percent.
Carey was diagnosed with Class IV congestive heart failure – the most advanced category. His heart’s main pumping chamber, the left ventricle, was enlarged and weak. Within days, cardiologist and electrophysiologist Richard Hongo, M.D., implanted an automatic internal cardiac defibrillator (AICD) to monitor Carey’s heart rhythm. If the AICD detects an abnormal heart rhythm, it delivers an electrical charge to reset a normal rhythm – although Carey notes his device has not done so in the nearly two years he has had it.
“My first three days in the hospital, the diuretics took nine pounds of water off my legs,” Carey recalls. “After I got the defibrillator and was discharged, I went home and was on a medication drip, which worked for a while. Eventually, though, I went back to the hospital and talked with Dr. Haeusslein and the VAD Coordinator, Rita Courville, about getting an LVAD.”
LVAD implantation was performed in June 2008. Now, a year and a half later, the LVAD continues to function well as Carey waits for a heart transplant. He also continues to participate in California Pacific’s nationally certified Cardiac Rehabilitation Program two times a week.
“The rehab program offers exercises specifically designed for cardiac patients,” Carey says. “They also have a nutritionist and classes to help you eat a healthy diet. Thanks to them, I have attained my goals. I’ve maintained my weight. I can walk up 75 stairs and walk seven to eight blocks around my neighborhood. I haven’t touched a cigarette since I was admitted to the hospital, even though I was a smoker for more than 20 years.”
In addition to therapeutic exercise, education and counseling to promote a healthy lifestyle, the Cardiac Rehabilitation Program offers medical assessments and supervision, along with psychological and social services. The cardiac rehab staff and the referring physician work together to develop each participant’s heart health plan, tailored to the individual’s needs.
A retired instructor, Carey says he has a new job ahead of him at age 63. “I now speak at conferences for the company that developed my LVAD,” he says. “I have a great story to share, letting people know the ‘ticker’ is not to be taken for granted.”