Buffalo man gets second chance with permanent heart pump

August 24, 2006

The HeartMate II ventricular assist device is being used as destination therapy for patients ineligible for heart transplantation.

Tom Evancho of Hamburg had been living with heart failure for years, since a heart attack damaged his heart muscle a decade ago. Doctors prescribed medications, and eventually implanted a defibrillator, but Evancho’s outlook wasn’t bright. What he needed was a heart transplant yet he wasn’t eligible due to other health issues. He was given six to 12 months to live.

When his defibrillator went off in spring 2006, it saved his life but also alerted his specialists in Buffalo that he was in end-stage heart failure and time was critical. He was referred to the Program in Heart Failure and Transplantation at the University of Rochester Medical Center, where team members made the decision to implant a ventricular assist device - the HeartMate II - as destination therapy, a long-term treatment that allows the patient to receive a life-saving device even though the patient isn’t eligible for transplant. Until recently, VADs served only as bridge-to-transplant solutions, to keep the patient alive until a donor organ becomes available, or as a therapy for recovery of a temporarily failing heart.

“This new direction in the treatment of heart failure makes it possible for us to help a population of patients who cannot get a new heart and whose only choice previously was to be medically managed as they became more and more sick,” said H. Todd Massey, M.D., surgical director of the University of Rochester’s program and director of the Artificial Heart Program.

Director Leway Chen, M.D., M.P.H., said destination therapy provides the patient with a greatly improved quality of life, allowing them to be relatively healthy, to be mobile and to gain extra time.

The device has been like a miracle for Evancho, who now can attend his grandchildren’s baseball games, which he often does six or seven days a week, walk around his property, and play with his dog, Bud.

“I feel very good, and better every day,” said Evancho, who has settled nicely into life at home again. “I am adjusting to the VAD and a whole lot of life changes, but I am so grateful to be here, to be able to spend time with my wife, Cindy, and my kids and grandkids.”

His family support, and that which he received from the medical team in Rochester, saved his life.

“Without my wife and family, and the doctors and nurses and everyone at the University of Rochester, I wouldn’t be here today,” he said.

Ventricular assist devices have become a significant component of the Program in Heart Failure and Transplantation and its Artificial Heart team, which has implanted VADs in more than 150 patients. More than 50 percent of VAD patients are bridged with ventricular assist devices while awaiting heart transplantation, with most of the patients being able to wait at home for long periods of time.

The Program in Heart Failure and Transplantation, part of the Strong Heart and Vascular Center, is the region’s only comprehensive heart failure and transplant service. It also is a national leader in research efforts to further the treatment of heart failure and return patients that suffer from heart failure to healthy and productive lives. Since the program was started in 2001, 79 patients have received transplants.

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Karin Christensen
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