Heart failure assist device brings hope for patients with end-stage heart failure

In early September, James Landsness’ end-stage heart failure made him unable to complete the 60-foot walk to his mailbox.

Today, Landsness does 27 daily laps to his mailbox for exercise, feeling stronger every day.

On Sept. 13, he became the first patient to receive a left ventricular assist device (LVAD) at Christiana Care, thanks in large part to the generosity of the Crystal Trust, which provided major funding for this advanced technology at the Center for Heart & Vascular Health.

“It’s like someone walking up to you and saying, ‘Here’s your life back.’ It really was amazing for me. I didn’t think something like that was possible,” Landsness says.

“I’ve taken care of Jim for many years,” says Henry L. Weiner, M.D., Landsness’ cardiologist. “He has always refused to constrain his life and work because of his heart disease. He’s fearless about medical technology. He embraced ICD therapy for ventricular tachycardia when it was new and ‘cutting edge,’ because he understood that it would be safer and allows him to be more active than traditional drug therapy.

“I think he’s had a similar attitude toward LVAD therapy. He sees the glass half full. It’s just how Jim is.”

Heart failure affects nearly 5 million Americans. Patients with advanced heart failure have often reached their maximal doses of medications and may have undergone coronary bypass or valve operations. The LVAD can represent a bridge to heart transplantation for some patients but can also represent their last opportunity for an improved quality of life without a transplant.

The current LVAD pumps have only one moving part and are designed to work for many years.

At the time of surgery, an LVAD is attached to the patients’ heart and aorta, and the pump is placed in the patient’s chest/upper abdomen. A controller connects the device via a driveline, which exits from the right upper abdomen. The patient wears the controller on a belt. Batteries weighing about a pound power the system.

Heart failure patients like Landsness who need the newest generation of LVADs now can stay home in Delaware for treatment, avoiding stressful and costly trips to Baltimore, Philadelphia or New York for the procedure. Christiana Care’s Center for Heart & Vascular Health is the only center in Delaware to implant the life-saving heart pumps.

“It’s an exciting opportunity to bring more advanced therapies for heart failure patients in our community” says Mitchell T. Saltzberg, M.D., medical director of Christiana Care’s Heart Failure Program. “Patients in the region can stay at Christiana Care for the procedure and maintain relationships with their local physicians.”

Ray Blackwell, M.D., and Harsh Jain, M.D., members of the cardiac surgery team who performed Landsness’ surgery, say the program will benefit Delaware patients and their families.

“This is a major opportunity for patients in Delaware with end-stage heart failure,” Dr. Blackwell says. “Short of transplant, the LVAD represents the most advanced technology for the treatment of heart failure.”

“It supplements medications and other heart failure-related devices,” adds Dr. Jain.

The average hospital stay for patients who receive LVADs is 16 days.

“The Heart Failure Program’s multi-disciplinary approach gives patients access to a full spectrum of providers, from cardiologists, surgeons and nurses, to therapists, pharmacists and behavioral health specialists, as the patient undergoes this complex procedure,” Dr. Saltzberg says.

“Many patients may not even be aware of this treatment option, or realize that they do not have to be critically ill to qualify for the procedure,” he says. “We’re very proud of the enthusiasm and support of Christiana Care Health System as we embark on this new program. This is truly a life-changing pump. At the end of the day, we want to provide outstanding care to the patients in our Heart Failure Program.”

“Everyone at Christiana Care is just fantastic,” Landsness says. “That goes for my cardiologist, the Heart Failure program staff, the OR nurses and the nurses on the floor. Even the cleaning staff. Everyone was just amazing.”