Lifesaving VAD Technology: "Like a Hybrid Care for the Heart"

Ernest Scruse, Jr. had never had a heart attack or even chest pains. But when shortness of breath and extreme sweating brought him to his doctor, he learned that his symptoms were signs of a potential heart condition. His doctor sent him to Baystate Medical Center, where the team there implanted a pacemaker and started a prescription drug regimen. But Ernie's condition continued to worsen, leading to a difficult discussion with his doctor.

“I was told by my doctor that the left side of my heart was taking in 100% of the blood but only pumping out 10%,” says Scruse. “He sat me down and told me that I was in heart failure and that the pacemaker and medicine were not working. He then told me that I was a prime candidate for the VAD [ventricular assist device].”

Scruse’s VAD implantation was the first of its kind to be performed at Baystate Medical Center and also the first to be done in the region. Today, the ventricular assist device (VAD) is much more than a medical device that he must wear every day. The VAD is truly a lifesaver.

What is a VAD, and how does it work?

 A ventricular assist device (VAD) is a mechanical pump that is used for patients who are in advanced heart failure. The pump is surgically implanted in a sac around the heart (known as the pericardial space) and helps the left ventricle pump blood to the rest of the body. The pump is connected directly to the heart at the bottom left ventricle where it draws blood through the aorta and allows it to flow throughout the rest of the body. A driveline, connected to the pump, exits the body through an opening in the abdomen and is connected to the controller. The device needs to be connected to a power source at all times, whether that is plugged into an outlet or relying on its battery packs that allow the patient more mobility.

Like a Hybrid Car...for the Heart

“It's a lot like a hybrid car in that it is an electric assist for the heart,” said Dr. David Deaton, thoracic and cardiac surgeon at Baystate Medical Center. “Ventricular assist devices are blood pumps that move the blood to some extent instead of the heart; however, the heart also can move some of the blood as well. It is somewhat like a hybrid car where you have both the electric off engine and the gasoline engine and they work together to power the car.”

Having a VAD allows most patients with advanced heart failure to return to a fuller life and increases their life expectancy.

Who qualifies for a VAD?

A patient must be showing symptoms of advanced heart failure to qualify for a VAD, including:

• The left side of the heart must be significantly dilated and weakened.
• The right side of the heart must function well enough to support the device.
• The patient's heart condition  must be limiting their quality of life.

Basically, there is a fine line between being sick enough to need the device and healthy enough to withstand the surgery. Doctors also look at a candidate's social and psychological support as an important factor.

Lucky for Scruse, his case was a perfect fit for the program.

“His condition had deteriorated over about a year or two and resulted in his having severe limitations of function and then eventually he had advanced heart failure symptoms. He couldn’t get around much,” said Dr. Gregory Valania, Scruse’s cardiologist.

Facing his fears

Although he was extremely grateful to have another option in terms of treatment, Scruse had to come to terms with his feelings on the pending procedure.

“I was scared. I was really scared and even thought about backing out of the surgery. But I had to think about my parents, my siblings, my kids. I had to say to myself, ‘Ernest, it’s going to end up hurting them more than you if you don’t go through with it,’” Scruse said.

The lifesaving surgery

After completing two weeks of pre-op appointments and blood work in the hospital, Scruse returned home for one week and was then admitted to the hospital the day before his procedure.

“There are really only three main centers that do this procedure and we feel really great about being one of them. We are the only center outside of the Boston area that does this. I think it’s something to be proud of in the region.” said Dr. Gregory Valania, cardiologist.

Returning home

Although the procedure went well, Scruse did face some complications including bleeding and blood clots. These are both common side effects for patients going through this type of surgery. After his condition stabilized and he overcame some expected setbacks, he was discharged after spending 51 days at Baystate Medical Center.

Initially, patients like Scruse are monitored bi-weekly by the VAD coordinator and see a member of their physician team once per week. As they recover, those visits become less frequent.

Rehabilitation

Scruse attributes his new found stamina to the work he has been putting in at Baystate’s cardiovascular rehabilitation program, one of the largest and most comprehensive programs in New England. For over 30 years, this program has helped patients recover from heart and vascular problems and return to their optimal health.

Thanks to the VAD and its ability to function on battery power, Scruse, an avid fisherman, is looking forward to heading out on the water with his father. “We go on a nice big boat and head out on the ocean. We usually start up in New Bedford and then go to Niantic or the Cape and catch sea bass, porgy, blues and stripers,” said Scruse. “It’s a great getaway and helps you get away from all of the stress and clear your mind.”

With his VAD procedure behind him and Baystate’s heart failure team by his side, Ernest Scruse, Jr. has a new lease on life.

“I am very grateful that I had the procedure done. I really don’t think I would be here right now without it,” he said.

Heart & Vascular care at Baystate Health

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