By Taresh Mistry
Lina Amaral cherishes the two young granddaughters she never would have met, had it not been for the tiny device in her heart that keeps her alive.
The Toronto woman had difficulty believing she’d live long enough to become a grandmother. Her doubt was justifiable — she had nearly died on several occasions over the years since she was diagnosed with Cardiomyopathy in her early forties.
But this past summer, as Amaral marked her ninth year living with a Left Ventricular Assist Device (LVAD) — a record length of time in Canada for a patient with an LVAD system — she also celebrated the birth of two granddaughters less than two months apart.
“It’s been a challenge, but I’m still here, you know, as long the good Lord wants me to be,” she says. “I told my doctors I wanted to stay alive long enough to see my first grandchild, and now I have two beautiful granddaughters. My blessings outnumber my challenges.”
Amaral is among approximately one million Canadians currently living with heart failure, who have a mean survival rate of just over two years.
Amaral’s heart problems began in middle age when she was a busy mother of four daughters and grew progressively worse until she was identified as a heart transplant candidate. Initially, she relied on a variety of medications to treat her illness and improve blood flow, but nearly a decade ago her medical team decided more medicine alone was not going to keep her heart working. She also experienced several additional health complications which ruled out a potentially life-saving heart transplant.
The cardiology team at Toronto General Hospital and surgeon Dr. Vivek Rao implanted an LVAD in Amaral’s heart — a Medtronic HeartWare HVAD System — which has allowed her to beat the odds for the past nine years.
“I didn’t think I would make it this far. It’s a big blessing,” Amaral says.
The HVAD System features the world’s smallest, commercially available, centrifugal flow pump. Weighing only 160 grams, the system’s continuous flow pump is 30 percent thinner and has 38 percent less volume than other centrifugal-flow devices.
Earlier this year, Health Canada authorized the HVAD System as destination therapy for patients like Amaral with advanced heart failure who are not candidates for heart transplants. Many patients with end-stage heart failure have other medical conditions or health histories that make them ineligible for a heart transplant. The HVAD System is also available as a bridge to heart transplant in eligible patients.
Health Canada also authorized a less-invasive implant procedure for the HeartWare HVAD Pump, making it the only LVAD licenced in Canada for implant via thoracotomy. The procedure involves a small, lateral incision between the patient’s ribs on the left side of the chest instead of the traditional median sternotomy procedure, which requires more-invasive surgery to divide the sternum. Thoracotomy has been clinically shown to reduce the average length of recovery in hospital and higher patient satisfaction.
Now that funding in Ontario has been made available to implant the HVAD System in destination patients as well as those awaiting heart transplants, Dr. Rao has said he hopes to see more patients benefit from the technology.
Dr. Rao and his team currently implant approximately 30 of the devices annually, but they’ve set a target to increase that number to 90 implants annually in three years.
“Patients with heart failure who are not transplant candidates typically only have one or two years to live,” says Dr. Rao. “But those who get ventricular assist devices can get their life back and can remain active. They’re not restricted by heart failure anymore.”
Amaral is making the most of her new lease on life and enjoying every minute with her growing family.
“Be thankful every day that you wake up, that’s my philosophy,” she says. “If you’re alive in the morning and get to go to sleep in a cozy bed at night, you should be grateful.”
Worldwide, more than 18,000 patients have received the HVAD System since it was first approved in Europe in 2009.
Taresh Mistry is the Marketing Manager for Mechanical Circulatory Support & Heart Failure Solutions at Medtronic Canada