Special Report: Life and death in the age of the bionic heart
By Toni Clarke and Debra Sherman
BOSTON/CHICAGO (Reuters) - In September 2007, Verna Schrombeck gathered three of her six children -- those who could bear it -- to discuss her funeral arrangements. She had been given just months to live and was about to undergo a last-ditch, cutting-edge heart surgery. There was no guarantee she would return home.
Had she organized things well enough, she wondered, so that her eldest son, who was in charge of the estate, would not be burdened? Had she taught her handicapped son, an adult, enough life skills to take care of himself? She asked that the Ave Maria be played at her funeral.
A week later, Verna's sister drove her 8 hours from Lowell, Indiana to Rochester, Minnesota, to the Mayo Clinic, one of the country's best hospitals for heart surgery. Her daughter flew in from Kansas. By the time Verna arrived at the hospital she could barely walk to the admissions desk. "I leaned over the railing, gasping for breath," she said. "I told my daughter, "you have to get me a wheelchair."
Verna, now 78, was suffering from heart failure, a progressive condition that, in its advanced stages, makes walking even a few feet difficult. She had received multiple treatments, including drugs and an implantable heart defibrillator, but nothing was working. In a final Hail Mary, doctors decided to implant an experimental, battery-powered mechanical heart pump known as a left ventricular assist device, or LVAD, into a cavity in her abdomen to assist her heart in pumping.
By the time she returned home, Verna, who received the device as part of a clinical trial, was able to dispense with her oxygen tank and take on household chores. Three years later, she is teaching piano to her five great-grandchildren, cooking meals for her family and driving by herself.
"It has transformed me," she said.
The device, called HeartMate II and made by Thoratec Corp, was approved by U.S. health regulators in 2008 to keep patients alive while they waited for a heart transplant. But in January, it was approved for permanent use in patients who are ineligible for a transplant, expanding the number of potential recipients from a few thousand to tens of thousands, and potentially changing the landscape for the treatment of end-stage heart failure.
"There has been a ten-fold increase in the use of these devices since they were approved for permanent use," said Dr. Lynne Warner Stevenson, Professor of Medicine at Harvard Medical School and director, Cardiomyopathy and Heart Failure at Brigham and Women's Hospital in Boston. "We are going to know a lot more a year from now but my anticipation is that it will have been the approval of this device in January that will have really set the field in motion." Continued...