Friday, September 21, 2007

Balancing act–finding a device that sustains life

Denise Mallen says she always tries to find the balance in her life between work, traveling and her loved ones. But at the age of 43 her life balance was thrown off with a diagnosis of cardiomyopathy—a damaged heart muscle, most likely caused by a virus.

Mallen’s physician, Marc J. Semigran, MD, director of the Heart Failure and Cardiac Transplant Program at the Massachusetts General Hospital Heart Center, also treated her when she experienced her first symptoms of congestive heart failure two years later.

A condition caused by severe heart muscle damage, congestive heart failure occurs when the heart is unable to efficiently pump fluid out of the body. The heart’s weakened pumping action causes a build-up of fluid (called congestion) in the lungs and other body tissues.

The Ups and Downs

Balance once again returned to Mallen’s life as the latest medications for her condition enabled her to live a normal life.

"I never felt my life was at risk, and I was very comfortable with Dr. Semigran," says Mallen. "I told him that I wanted to live to be 100. He told me that he would get me to the age of 80 and then I was on my own!"

Even though Mallen was traveling, working and living a normal life, her heart function began to decline, which is the normal progression of a damaged heart muscle. Mallen had become so weak that she was unable to function. “I was unable to carry a quart of milk,” explains Mallen.

Admitted to Massachusetts General Hospital in early 2006, Dr. Semigran made it clear that Mallen needed to be on the transplant list. But after four weeks on the list, she had not received a new heart.

Weaker than ever, Mallen weighed only 83 pounds because her heart condition prevented oxygen from reaching vital organs. “Two people would have to hold me to help me stand. I was extremely weak,” says Mallen.

Sustaining Life

To assist Mallen while she waited for a heart transplant, Stephanie Moore, MD, heart failure and transplant cardiologist, recommended the implantation of an LVAD, also known as a left ventricular assist device. An advanced treatment for cardiac patients, the LVAD takes over much of the heart’s function. The device sits near the diaphragm with one end connected to the aorta and the other to the left ventricle.

Dr. Moore strongly believes that the LVAD can support the lives of many patients who are either waiting for a transplant or who do not qualify for a transplant.

"With the advances of mechanical support, we are able to give patients their lives back. The artificial heart in many ways provides real hope," says Moore.

But Mallen still wanted a new heart rather than an implanted device. "I wanted to wait in the hospital for a new heart," says Mallen.

Tom MacGillivray, MD, cardiac surgeon at Mass General Hospital Heart Center told Mallen that his job is to make her well, and while a new heart would do so, they could not control when she would receive the heart. They could, however, give her an LVAD to sustain her life.

"After six weeks on the LVAD, I was able to leave the hospital," continues Mallen, "Within four months of leaving, I was thriving. I was given a goal to live my life. I had wonderful energy."

A Transplant and a Return to Balance

After 14 and a half months using the LVAD, Mallen received a heart transplant on May 14, 2007. Her condition was strong, largely due to her excellent health in the months leading up to the surgery.

Today Mallen balances the healing process following major surgery by spending valuable time with family and friends. She is grateful for the gift of her donated heart, the skill of the Heart Failure and Cardiac Transplant team, and her faith throughout the entire process.

She also hopes to contribute to the selfless act of organ donation, either through education, advocacy or another means.

"Donation is the greatest gift that anyone can give," says Mallen, "I hope to continue focusing attention on the need to donate one’s organs. There is no greater gift."

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