Wed | Jan 23, 2019

New hope for Caribbean patients with end-stage heart failure

Published:Wednesday | September 16, 2015 | 12:00 AM

A new alternative to heart transplants could change the outlook for many patients in the advanced stages of congestive heart failure. The procedure is called left ventricular-assist device (LVAD or VAD), and it involves a mechanical pump that is implanted inside the patient's chest to help a weakened heart ventricle pump blood throughout the body.

Dr Brian Bethea, regional medical director of cardiovascular surgery at Tenet Florida, and his team recently performed the first LVAD surgery at Delray Medical Center - the only hospital between Orlando and Ft. Lauderdale to offer the breakthrough heart therapy.

"What patients with heart failure need to know is that LVADs may help them feel better and live longer than previously possible," said Bethea.

According to data released by CARICOM from its strategic plan of action for the prevention and control of chronic non-communicable diseases, the Caribbean region has the highest death rates from heart disease in the Americas. Predictions indicate that the number of people with ischemic heart disease will triple within the next two decades.

"With the rise in chronic non-communicable diseases in the Caribbean, congestive heart failure is reaching alarming epidemic proportions in the region," said Dr. Henry Steward, a cardiologist in Curacao and president of the Caribbean Cardiac Society, a regional association of cardiologists across the Caribbean.

progressive & often fatal condition

For many of these individuals, their condition will progress to what is commonly referred to as chronic, advanced or severe heart failure - a progressive and often fatal condition that weakens the heart so it is no longer able to pump enough blood to meet the body's needs.

"Frequently, advanced congestive heart failure is a downward spiral, an existence punctuated with recurrent hospitalizations," said Dr. Bethea.

The disease not only significantly limits life expectancy - with a typical prognosis of six to 12 months - but it robs patients of their quality of life, often leaving them too short of breath or too tired to go out, travel or even dress themselves.

Traditionally, their only hope has been a heart transplant. However, with only about 2,000 donor hearts available each year, the demand for hearts inevitably outweighs the supply.

Dr. Steward believes that LVAD will significantly benefit many Caribbean patients who do not qualify for a heart transplant or have not improved from other forms of treatment. He commends the partnership being forged between Tenet Florida, the Caribbean Cardiac Society and regional physicians to develop and implement shared protocols, training and resources to offer this life-saving treatment.

"An integrated team, encompassing input from all providers, is absolutely critical to improving the quality of life of these complex patients," added Bethea.

"Our goal is to work with our partners in the region to provide a comprehensive heart-failure treatment programme, in collaboration with our extensive multidisciplinary team at Delray Medical Center."