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Pump helped to mend his broken heart

Jimmy Hathcock faced a heart transplant, but a device intended to be a temporary aid allowed his heart to heal.

ATOYIA DEANS | Times

Jimmy Hathcock faced a heart transplant, but a device intended to be a temporary aid allowed his heart to heal.

TAMPA

Jimmy Hathcock arrived at Tampa General Hospital in February by medical helicopter, with a heart so damaged he was put on the list for a transplant. Now the 67-year-old is out of the hospital, with his own heart beating in his chest. Most people get off the transplant list only when they find a donor or die waiting. Hathcock, however, got off the list thanks to breakthrough technology that allowed his own heart to heal. "Getting off the list because they get better is pretty rare,'' said Dr. Cedric Sheffield, director of the Heart Lung Transplant program at Tampa General Hospital. In the past seven years, 179 patients were put on a ventricular support device like the one that saved Hathcock. Only three came off the device and recovered without getting a donor heart. It's a small number, but one that offers hope to the most critical patients, given the shortage of donor hearts, Sheffield said.

Severe damage

Hathcock, a Lakeland man who's always been trim and active, started feeling very tired last Christmas. Normally easygoing, he was often grumpy. He swigged Mylanta for indigestion.

In January, his family doctor ordered a battery of tests, so many that an annoyed Hathcock threatened to cancel a cardiac catheterization to check for blockages. But his longtime partner, Barbara Martini, insisted.

Tests revealed that Hathcock had aneurysms on four heart vessels. An aneurysm is a weakened area that bulges like a bubble on a bicycle tire. If it bursts, the patient could bleed to death. Hathcock needed bypass surgery right away.

The St. Petersburg native checked into Bayfront Medical Center for surgery that turned into a 10-hour ordeal. Hathcock had to be revived three times because of the aneurysms. He had a heart attack, his lungs filled with fluid, his kidneys started to fail and doctors couldn't take him off the heart-lung machine.

They called Sheffield, who suggested the Bayfront doctors fit him with a temporary heart pump so he could be flown to TGH for a longer-term solution. Sheffield replaced the temporary pump with the Abiomed AB5000 Ventricle, which he selected because the first pump also was an Abiomed, making the transition smoother. Also, it is portable, allowing patients to walk as they recover.

The device, approved by the Food and Drug Administration in 2004, takes over the job of pumping blood, giving the heart muscle a rest. The pump sits outside the body on the abdomen and is connected to the heart by thin plastic tubes inserted through two small incisions, made at waist level. An external console on wheels, about the size of a small suitcase, drives the pump.

Abiomed, based in Danvers, Mass., won't release the cost of the device, because prices are determined by contracts with hospitals. It is covered by most private insurance and Medicare.

Sheffield estimates the device's cost at about $55,000 to $75,000. The cost of implanting it, he says, is in line with that of a heart transplant, around $250,000.

Against the odds

Sheffield wasn't optimistic about Hathcock.

"His situation was acute, very severe. I seriously doubted he had much chance for recovery."

By early March, after a month on the AB5000, Hathcock was starting to improve. By late March he was walking the halls of the transplant unit, pulling the device behind him.

On April 20, Hathcock became the first patient in the world to take the portable ventricle home with him. He even felt well enough to do some office work for his family trucking business.

Surprising progress

During a routine checkup early this month, doctors got a surprise. Hathcock's heart had healed so much, they put him back in the hospital and started gradually reducing the power of the pump to see if the heart could do more of its own work. On Aug. 7, the AB5000 was removed.

Hathcock will continue to take medications, must go through cardiac rehab and will be closely monitored. Sheffield expects he'll continue to improve, but cautions that a third of patients who go off ventricle pumps later do need a heart transplant.

Reflections, gratitude

Sitting up in a lounge chair at TGH last week, Hathcock joked with visitors and talked about the two decades he spent traveling the United States and Canada, singing and playing guitar with his country band, Jim Lamar and the Jimbos.

"They say that's probably where this (heart disease) came from. All the passive smoke in those clubs and lounges," he said.

Hathcock left the hospital for home last week, and realizes a full recovery will take time. He still tires easily and is adjusting to new medications. Wednesday, he was back in Tampa for a checkup. So far, so good.

"We attribute his recovery to the Abiomed,'' Martini said. It saved his life."

Added Hathcock: "I'm just thankful to the good Lord it worked."

Irene Maher can be reached at imaher@ sptimes.com or (813) 226-3416.

Pump helped to mend his broken heart 08/26/09 [Last modified: Thursday, August 27, 2009 2:43pm]
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