VCU news

By Joe Kuttenkuler

At first glance, these backpack-toting pedestrians look and move pretty much like anyone else. Get closer, and the rhythmic sound tells you they are unique, and an inspection of the backpack would reveal contents that are anything but ordinary. 

They are patients with total artificial hearts and they are becoming familiar sights walking the hallways of the Virginia Commonwealth University Medical Center’s Pauley Heart Center. The metronome-like thumping emanating from the backpack is from a portable pump – or driver – that powers the mechanical heart inside the patient. February is American Heart Month, and the portable driver is one of a number of innovative approaches to heart health being employed at the Pauley Heart Center.

The driver runs 24/7 at roughly 120 beats per minute. For passersby, it’s a source of curiosity and amazement. For patients, it’s the sound of life and freedom.

“It’s my temporary heartbeat and it’s kind of soothing,” said Jarrod Russell, a total artificial heart patient at VCU and one of only a handful in the country to be connected to the portable driver. “I feel so normal now that sometimes I’ll move to get out of bed and suddenly remember I’ve got to grab the backpack.”

Just 32 years old, Russell began feeling ill last November and was diagnosed with bilateral pneumonia. A family history of heart disease led to an echocardiogram that revealed an enlarged, poorly functioning heart. Despite the premature deaths of his father and grandfather from heart complications, Russell admitted he was a little surprised he was having heart issues so soon.

“Knowing my history, I’ve made a conscious effort to live a healthy life – no smoking, staying in shape – but you never know,” Russell said.

Several procedures to save his ailing heart failed. He needed a new one soon. So, on Dec. 9, Russell received a total artificial heart that will keep him alive until a donor heart becomes available.

“Transplants don’t happen on a predictable basis, so this technology enables these very ill patients to wait for a transplant and actually get healthier while doing so,” said Vigneshwar Kasirajan, M.D., chairman of cardiothoracic surgery and director of heart transplant and mechanical circulatory support.

Following surgery to implant the device, all patients awake tethered to a large, 400-pound console – nicknamed Big Blue – that powers the heart. The Pauley Heart Center team wastes no time getting patients moving and, with assistance, Big Blue rolls with the patient on walks and to physical therapy.

Almost immediately, patients begin to feel better. The total artificial heart restores a healthy blood flow to a body weakened by the ravages of end-stage heart failure.

After several weeks of recovery, patients who meet a variety of criteria have the option of being transferred to the portable driver and ultimately a chance to recover at home until a donor heart becomes available.

“I was a little apprehensive at first,” Russell admitted, when doctors first discussed the idea of transferring him to the portable unit, “but now, it’s so nice to be able to move around more freely. I can go anywhere.”

Since being connected to the portable driver two weeks ago, Russell has been cruising the halls, working out daily in physical therapy and venturing outside for short walks.  Recently he even attended a benefit in his honor at a nearby club, accompanied by two nurses – something that would not have been possible with Big Blue.

“I think it will be good for these patients to be at home and recover while they wait for a transplant - not just physically, but psychologically as well,” said Kasirajan who is the principal investigator of a multicenter, nationwide study of the Freedom Driver.

The Pauley Heart Center’s total artificial heart program launched in 2006 and has evolved into the most prolific program in the country, with 50 mechanical hearts implanted thus far. Combined with nearly 20 years experience implanting left ventricular assist devices – which enhance the heart’s pumping function – and an array of technology and procedures to treat irregular heartbeats and blockages, the Pauley team has built a comprehensive mechanical circulatory support and heart failure program.

Unlike Russell, Margaret Doughterty is familiar with the transplant process – this is her second time on the waiting list. The heart she received 18 years ago began failing and required that she receive a total artificial heart while she waits for another. Her subsequent transfer to the freedom driver made her only the second female patient in the U.S. to be connected.

“I hope to be an inspiration to other people that see the portable driver as an option worth considering while they wait [for a transplant] on the list,” Dougherty said. “It’s great.”