Upstate New York’s 1st Total Artificial Heart Patient Leaves URMC Following Successful Heart Transplant

Hockey great Gaetano Orlando today leaves the University of Rochester Medical Center grateful to the team of cardiac experts who implanted a temporary total artificial heart in his chest and the generous stranger who subsequently donated a heart.

H. Todd Massey, M.D., URMC cardiac transplant surgeon, performed the total artificial heart procedure April 4, 2012 and the life-saving heart transplant Feb. 4. URMC’s Strong Memorial Hospital is the only Upstate New York hospital approved to perform heart transplants.

“Every night I pray for the donor who helped me and other people. I am able to go home to my family and go back to my life,” said Orlando, who played for the Rochester Amerks in the 1980s and the Italian national team in the 1994 and 1998 Olympics.

URMC’s heart failure and transplantation team applauds Orlando’s steady recovery from heart failure.

“Mr. Orlando put his trust in us when we provided the cutting-edge technology that we are able to provide and he has done amazingly well. It makes all of us proud to see patients thrive and everyone who has cared for him today shares in this celebration,” said Leway Chen, M.D., M.P.H., medical director of the Program in Heart Failure and Transplantation, a part of the URMC Heart and Vascular Center.

Orlando is committed to raising awareness about organ donation and the importance of building the donor registry. In New York, there are 10,000 people waiting for organs, more than 112,000 in the country. Among them, 3,200 need new hearts, including 43 people who are waiting for a transplant at URMC.

Sadly, fewer than 20 percent of New Yorkers have joined the donor registry, according to Rob Kochik, director of the Finger Lakes Donor Recovery Network, the organ procurement agency that coordinates organ and tissue donations in the Finger Lakes, Central and North Country regions.

“It’s important to think about being a donor and talking with your family about your wishes. So many lives could be saved if more people decided to be organ donors,” said Orlando, 50.

Massey, heart transplant surgeon, marvels at Orlando’s recovery and said “he was a model patient. He committed himself to staying healthy enough to get a new heart when one became available. No one wants to be in the hospital as long as he was and he exercised every single day and was able to keep his spirits up.”

Orlando was diagnosed with sarcoidosis, a rare form of heart failure that affects all four chambers of the heart, in early 2011 and transplant cardiologist Eugene Storozynsky, M.D., Ph.D., managed his heart failure care. The disease progressed and he participated in a URMC clinical study of a new external defibrillator, called LifeVest, to monitor and treat life-threatening heart arrhythmias in patients with newly diagnosed heart dysfunction.

This wearable device saved the retired hockey player’s life when his heart stopped beating and it delivered a therapeutic shock to restore the regular rhythm.

Orlando’s heart function continued to deteriorate and Storozynsky prepared for the possibility of a heart transplant. He joined the waiting list in early 2012 and in April his heart failed suddenly, prompting doctors to move swiftly with placement of the total artificial heart because a suitable donor heart was not available.

“He exceeded our expectations for a quick recovery given how gravely ill he was going into the surgery,” Storozynsky said. “The total artificial heart afforded him valuable time to recover and wait for the gift of life.”

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. More than 1,100 of the high-tech heart pumps have been used in patients worldwide.

The total artificial heart is powered with air and vacuum provided by a pneumatic driver. That machine weighs more than 400 pounds, requiring patients to remain in the hospital initially. As Orlando recovered, he transferred to a smaller, portable driver that allowed him to return home.

“This is tremendous technology that can have a dramatic effect on patients who are experiencing advanced heart failure,” said Massey, surgical director of the URMC Artificial Heart Program, a component of the heart failure and transplantation program. “For some patients, it is the only option for survival until a donor heart becomes available.”

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 with the high-tech heart pump before receiving a successful heart transplant, according to SynCardia, which makes the device.

Although transplantation is still the treatment of choice for those with end-stage heart failure who do not respond to other medical or surgical treatments, a shortage of donor organs limits the option of transplantation for many, Massey said. URMC is one of 40 sites in the country, and one of just three locations in the state, to offer this life-saving technology.

“This is another option in our growing arsenal of devices used as a bridge to transplant. The advances in technology and care in the past 20 years have allowed us to extend the life of many more patients with heart failure,” said Storozynsky.

“This can be a life-saving measure for patients whose only other option is an immediate heart transplant,” Massey said. “The total artificial heart leads to recovery of organ function in the most critically ill patients, allowing for a heart transplant when the patient is more stable - which ultimately helps achieve better outcomes following transplantation.”

The total artificial heart is vastly different technology than other heart pumps such as the left ventricular assist devices (LVAD) where the heart remains inside the patient. Massey has implanted more than 1,000 LVADs and other heart pumps in URMC patients.

The URMC Heart and Vascular Center 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 SynCardia implantation. The Program in Heart Failure and Transplantation and its Artificial Heart Program are dedicated to providing state-of-the-art care and cutting-edge technology to extend survival.