To say that Ronald Fontana is heartless may sound cruel, if it weren’t true. Doctors at UR Medicine’s Strong Memorial Hospital replaced the heart of the 64-year-old Camillus man with a total artificial heart, a high-tech device that offers hope for people with end-stage heart failure. It also gives him time to recover as he waits for a heart transplant.
Fontana is the first Central New York resident to receive a temporary total artificial heart. Cardiac transplant surgeon H. Todd Massey, M.D., performed the life-saving surgery last fall.
“It is strange that I don’t have a heart right now,” said Fontana, who is anxious to see the skyline over Onondaga Lake as he returns home. “I have plastic technology hooked up to a machine that is keeping me alive and every now and then I realize just how scary that is.”
The Syncardia temporary total artificial heart is a bridge to transplant for patients who suffer from end-stage biventricular heart failure, a condition in which both sides of the heart become weakened and cannot pump blood adequately throughout the body. The device is powered with air and vacuum provided by a pneumatic driver. More than 1,300 total artificial hearts have been used in patients worldwide to date.
To implant the total artificial heart, surgeons remove the left and right ventricles and valves of the heart, leaving the left and right atria, aorta and pulmonary artery intact. Patients have lived for nearly four years before receiving a successful heart transplant.
“The total artificial heart is a significant technological advance that can have a dramatic effect on patients who are experiencing advanced heart failure,” said Massey, who performed the surgery. “For this patient, it was the only option to keep him alive until a donor heart could become available.”
Fontana has suffered with heart disease for decades. He was diagnosed with cardiomyopathy – a broad term for a weakened heart muscle – and his cardiologist Eugene Lozner, M.D., of the New York Heart Center, managed his heart function with medications, implantable defibrillator and pacemaker.
Two years ago he began experiencing ventricular tachycardia, a condition that causes the heart to race, and his pacemaker delivered the electrical charge to normalize the rhythm. After a few of those episodes, Fontana’s cardiologist referred him to Spencer Rosero, M.D., an electrophysiologist at Strong Memorial Hospital. In February 2013, Rosero performed a ventricular tachycardia ablationto help resolve the problem. But the v-tach, as it is often referred to, returned with a vengeance six months later and Fontana was hospitalized at Strong Memorial.
“It became apparent quite quickly that we couldn’t control it and we had to implant the total artificial heart or he was not going to survive,” said Jeffrey Alexis, M.D., his transplant cardiologist with the Program in Heart Failure and Transplantation.
UR Medicine’s team moved swiftly and the surgery was performed Sept. 24. Fontana awoke tethered to a machine that keeps the pneumatic system pumping blood through his body. The steady beat can be both comforting and maddening, he said.
“It’s kind of like bongo drums with a whoosh-whoosh in there too,” said Fontana. His wife, Toni, has been by his bedside in Rochester for the past nine months. She stayed at Harbor House, which provides temporary lodging for families of adult critical care patients who live outside the Rochester area. It offers a “home-away-from-home” that eases the emotional and financial burdens on families.
Recovery took months and Fontana has learned to live with the machine keeping him alive. In the past few weeks, he has been able to down-size to the 13.5-pound Freedom Driver, a suitcase-sized machine on wheels, designed to allow greater mobility. He will return to his home with this technology, where he will wait for the donor heart.
Upstate New York has some of the longest wait times for donor organs because the state has one of the lowest donor registry rates in the nation. In New York, there are 11,000 people waiting for organs, according to the Finger Lakes Donor Recovery Network.
“This has really opened my eyes to the importance of organ donation and we should all think hard about joining it and helping someone in need,” Fontana said. Anyone interested in joining the registry can go to: www.donorrecovery.org.
UR Medicine’s Heart and Vascular program is the region’s most comprehensive program, providing multidisciplinary care from the first warning signs of heart disease to sub-specialized treatments such as the total artificial heart.