The Jewish Hospital Heart Failure, Transplant and Mechanical Support Program (FRCP), a member of Kentucky Heart One Health and the University of Louisville announced an exciting new program in March of this year. You may recall from an earlier post that The Jewish Hospital was approved by the FDA to participate along with Cedars Sinai and Case Shuller in an extremely successful stem cell protocol for patients suffering end stage heart disease. The March announcement is unrelated to that study but is equally favorable.
Emma Birks, MD, PHD, the director of FRCP, announced that the hospital has discovered a medicine-based therapy that has enabled 11 patients on Left Ventricular Assist Devices (LVADs) to be disconnected from the device and return to their regular lifestyles. In most cases, the need for a heart transplant has been alleviated or delayed to unforeseen dates. As heart transplant patients on the wait list know, the installation of an LVAD is a very invasive procedure that is accompanied by a number of risk factors including serious infection that can place the patient on Status 7 or unsuitable for transplantation for long periods of time.
At Columbia Presbyterian, I was offered the option of an LVAD. When the physician described the surgery, she compared it to open heart surgery, which I had experienced 7 years earlier. That was all I needed to hear. I opted to wait until it was absolutely necessary. Fortunately, that never occurred.
At Columbia and at Tampa General, I met several patients with LVADs. One week I met a gentleman who looked deathly ill. He was that familiar shade of grey and very fragile. What was left of my heart went out to him.
Two weeks later the man attended a class and had an LVAD. He looked great. He was uncomfortable but his complexion was good and his skin color showed no signs of the severity of his illness. Suzanne and I stayed after class to chat with this man and his wife. He was happy and she ecstatic. Clearly worn by the waiting experience, he finally appeared to be safe and ready to wait longer, a very draining process.
Dr. Birks is a professor of medicine, physiology and biophysics. She is regarded highly in the profession. This new therapy is her biggest success to date. Her discovery may well change the way LVADs are viewed.
Her formula includes a number of ACE inhibitors, spironolactone, beta blockers, angiotensin receptor blockers and digoxin in concert with the LVAD. These elements work together to strengthen the patient’s heart. Two years ago, strengthening the heart in patients with end stage heart disease was deemed impossible.
Birks told the media that, “These patients have a very good quality of life much better, in fact, than if they continued on the LVAD alone or received a heart transplant.” Wow! How about that?
During an 18 month period, the program allowed 11 patients to remove their LVADs. In the US, only one other hospital, the Texas Heart Institute, has attempted the Jewish Hospital’s protocol. The Texas Institute has removed LVADs from 20 patients.
The protocol calls for pre-LVAD removal medicinal applications for a minimum of six months. In the most extreme cases, the medications may be needed for up to one year prior to removal of the LVAD. Birks was emphatic that the process could not be rushed.
Birks first began to work on the protocol in England where the doctor worked with Dr. Magdi Yacoub, a highly regarded heart transplant surgeon. Yacoub retired in 1998 and left Birks to carry the ball. She describes the medications as a “cocktail of oral heart failure medications.”
What heart failure patients will find interesting is that Birks, the Jewish Hospital and the University of Louisville have received approval for and will lead a trial program administered at several centers including:
- Texas Heart Institute
- University of Pennsylvania
- Cleveland Clinic
- University of Michigan
- Montefiore of New York
- University of Pittsburgh
The average life expectancy of a heart transplant recipient is ten years. Birks emphasized that for young patients the protocol can extend life and avoid or at least delay the need for heart transplantation. This is good stuff.
“The most rewarding thing in medicine is to help people heal,” said Birks. “If you have a young person, who is dying and you can help them avoid a transplant and return to good health, that is the ultimate challenge and is very rewarding.”
Well said. If you have questions regarding eligibility or how to enroll, please call the Jewish Hospital in Louisville. Best of luck and keep walking and eating healthy.