Living without a pulse

Jose Zabalza, a 53-year-old father of three had been prepared to die this year as his heart began to give out and it became increasingly difficult just to walk across his living room. But new technology is giving him a second chance, and letting the Fresno man make tentative plans to camp again with his three children and spouse.

The day after Thanksgiving cardiac surgeon Pervaiz Chaudhry and his team at Community Regional Medical Center  installed the Valley’s first portable heart pump – a device that gives new hope for those waiting for heart transplants. The hospital is the only one between Sacramento and Los Angeles with the expertise, technology and approval for the HeartMate II LVAD pump, according to the pump manufacturer. And it is one of a dozen or so in the nation approved to use the pump without a heart transplant program.

Jose Zabalza’s family jokes that he’s like a bionic man now with a whirring machine in his chest that pushes his blood around in one continuous stream, making it hard to find the classic pulse at his wrist or carotid artery. “It’s just like a faucet with the water coming out in one continuous flow,” Dr. Chaudhry described Jose’s circulation. “I’ve been a big believer in this technology. Everyone’s really excited about it. Our target now is to help more people – maybe even do as many as one a week.”

The HeartMate II, developed by Thoratec Corporation, is a continuous-flow pump that takes over the work for the heart’s left ventricle, the main pumping chamber. The small, lightweight device includes a pump implanted inside the body and batteries and a controller worn outside the body and carried in a pouch at the waist or in a vest that allows the patient to be active and mobile.

Two days before his historic surgery, Jose summed up his hopes: “I just want to live … live for my wife; she is my main drive. Plus I still need to pay off our home” His longtime companion Julie Souza said she wants to camp again and joked that she might even get a dog for them to walk.

Jose has suffered with congestive heart failure for the past 10 years and had to give up his trade as a sheet rocker, said his youngest brother Daniel Zabalza, a Fresno minister.  A pacemaker installed three years ago helped, but then Jose suffered from an infection in July and the pacemaker had to be replaced. A defibrillator this fall didn’t help.  He’s been admitted to the hospital seven times this year for heart failure, spending long stretches in the intensive care unit.

“We almost lost him,” Daniel says.  “This will give him a chance to wait for a new heart. They call it the bridge to a heart transplant.”

But Matthew Lyman, a Thoratec representative on hand for Community Regional’s first surgery, said for some patients the HeartMate is the destination treatment and considered a permanent fix.  “We don’t know yet how long it lasts…it used to be months but now it could be years for patients on the pump.”Lyman said he was impressed by the passion and expertise he saw in Community Regional’s cardiac team.

Bruce Eliason, director of cardiology at Community Regional, calls it “the cherry on top of our cardiac program.” His great hope is that it can keep patients like Jose out of the hospital and give them back their lives.

“Patients with congestive heart failure are among the highest cost to Medicare in this country because of their high rates of hospitalization. People are living longer with drugs we have available, but they’re not having a quality of life,” Eliason said. “This is the only thing that actually reverses the affects of heart failure – besides transplant.”

The HeartMate II inside Jose’s chest lies just below his heart, with the inlet tube attached to his left ventricle and the outlet connected to the aorta or main blood vessel. Blood circulates from the heart through the pump where a small propeller pushes the blood into the aorta and out to the rest of the body, relieving the work the heart normally does. A flexible tube passes through the skin and connects the tiny electric motor inside the body to the batteries outside the body. The HeartMate II can also be plugged into standard electrical power outlets. 

Jose’s family sees so many possibilities ahead with the portable pump taking over for his weakened heart.

“He hasn’t been able to go to a restaurant for years, to work, to do much. He’s only able to walk out the front door and back. That’s it,” Daniel said of his older brother’s health. “From what I’ve seen in the education videos with this, he’ll be able to take long walks again, to do things with his wife again, to lift his hands and worship his God again.”

This story was reported by Erin Kennedy and Nicole McGrath. They can be reached at MedWatchToday@CommunityMedical.org.