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New tech helping heart patients

Erica Shea, with 3-year-old son Ryder, suffers from advanced heart failure. She has an implanted ventricular assist device, which is powered by belted batteries she wears around her waist. She is a top priority for a heart transplant.
Erica Shea, with 3-year-old son Ryder, suffers from advanced heart failure. She has an implanted ventricular assist device, which is powered by belted batteries she wears around her waist. She is a top priority for a heart transplant. Justin Saglio for The Boston Globe/Globe Freelance

Erica Shea awoke at 2 a.m. the day before her son’s second birthday party.

“I was on the floor, throwing up; I’d turned white as a ghost. I couldn’t talk; I couldn’t move,” said Shea, 29.

Boarding an ambulance to Brockton’s Good Samaritan Medical Center, she was able to tell her husband to go ahead with the party and that she would be home soon, “thinking it was nothing, no big deal,” she said.

A few hours later, a doctor called to ask her husband about her final wishes, saying that if she did not get to a Boston hospital in the next 45 minutes, she would likely die.

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“My mother . . . looked at me and was like, ‘Well, what did they say?’ and I think I just broke down and started crying,” said David Shea, 27. “It was very scary.”

One year later, Erica Shea is alive and, if not quite well, irrepressibly upbeat.

Suffering from advanced heart failure brought on by chemotherapy and her subsequent pregnancy, she is one of thousands of Americans being kept alive by ventricular assist devices that keep their blood flowing even though their heart muscles are too weak to pump it effectively.

 The HeartWare implanted ventricular assist device, approved in 2012 by the US Food and Drug Administration, continuously circulates blood into the body and connects through wires to relatively small external batteries that are worn as belt around the waist.
The HeartWare implanted ventricular assist device, approved in 2012 by the US Food and Drug Administration, continuously circulates blood into the body and connects through wires to relatively small external batteries that are worn as belt around the waist.HeartWare

“I’m just grateful that I got my Christmas tree up. I’m grateful I got Thanksgiving this year,” Shea said in her Brockton living room recently. “There’s always a reason to be grateful. This experience has given me that realization.”

Ventricular assist devices have been in use for heart failure patients since the 1980s, doctors say, but the latest generation — implanted pumps that continuously circulate blood into the body and connect through wires to relatively small external batteries — are a vast improvement over earlier versions that had large external mechanisms and required long-term hospitalization until a donor heart was available.

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“Having the technology in its current form, we can get most of these patients . . . living well outside of the hospital walls until a donor organ is available,” said Dr. Michael S. Kiernan, director of the Ventricular Assist Device Program at Tufts Medical Center, where Erica Shea is treated. “That really improves the quality of life of these patients who struggle with a terrible disease.”

The Duchesneau-Grogan family of Leominster has seen how ventricular assist devices have evolved over the past decade. David Duchesneau, 56, was diagnosed with heart failure in 2000, after he began coughing up blood while working a construction job.

He gave up drinking, smoking, and “eating fatty bologna, Italian sandwiches,” he said. Doctors implanted an internal defibrillator to support his heart, and his health was stable for about three years, until he developed a rapid heartbeat that became increasingly worse, requiring repeated hospitalizations.

In 2004, he was implanted with an earlier model, a “very cumbersome” ventricular assist device, which used an air pump that “sounded like Darth Vader,” Duchesneau said, and required him to remain at Tufts Medical Center for a month until a donor heart became available.

His sister Ann Grogan, 58, began experiencing lightheadedness and shortness of breath about a year after Duchesneau’s diagnosis, leading to her treatment with medications and an internal defibrillator and finally, in 2009, the implantation of a next-generation ventricular assist device for the month before her heart transplant.

Her device was smaller, quieter, and more mobile, but still unwieldy, she said, requiring a heavy external power source when it was not operating on battery power. It was a difficult time, she said, but she was grateful for the device. “The alternative was either stay in the hospital, or six feet under,” she said.

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Her son John Grogan, 30, saw what may have been his first hints of heart trouble when he was no more than 12 or 13 and he became disoriented playing basketball, running toward the other team’s basket. At 18 he was diagnosed with heart failure; at 21 he had an internal defibrillator; at 26 he was part of a trial for the newest ventricular assist device on the market.

John Grogan spent three years with the device before his transplant. It was smaller and allowed for more movement than the devices used by his mother and his uncle, but he had little energy and was limited by the device’s batteries, which lasted only about four hours.

John Grogan (right), his mother, Ann Grogan, and his uncle David Duchesneau all had similar implant devices that kept them all alive as they awaited heart transplants.
John Grogan (right), his mother, Ann Grogan, and his uncle David Duchesneau all had similar implant devices that kept them all alive as they awaited heart transplants.Dina Rudick/Globe Staff

A few rounds of golf and one Patriots game — with backup batteries and a power adapter for the car — are among the few activities he looks back fondly on from those years.

“But I felt much better than they did when they had theirs,” he said of his uncle and his mother.

Like the Grogans, most patients with ventricular assist devices are awaiting transplant, but the devices are also used as a long-term treatment for patients who are not good transplant candidates because of weakness, advanced age, or other medical conditions.

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“These pumps can last, really, years,” said Dr. Michael M. Givertz, medical director of the Heart Transplant and Mechanical Circulatory Support Program at Brigham and Women’s Hospital. “In our own program, we have one patient who’s coming up on her eighth anniversary of having this pump implanted. We have other patients who are out five, six, seven years with a single pump.”

For some patients too weak for transplants, the device can help make them strong enough that a transplant is possible. Some go from being barely able to walk to having full, active lives again following implantation of a left ventricular assist device, often called an L-VAD by doctors.

“We have patients hang-gliding with an L-VAD,” said Givertz. “I have a patient who’s a racecar driver with an L-VAD. . . . I have a patient who taught karate with an L-VAD. It’s really quite remarkable.”

There are limitations imposed by the devices. Patients must be careful to avoid infection at the site in the abdomen where the power line leaves the body. The external batteries must be kept dry, making showers a chore, and they are heavy and must be carried in a vest, holster, shoulder bag, or a Batman-like utility belt.

In the future, doctors hope the devices will be more compact and fully implantable, powered remotely so that no wires lead out of the body.

“We don’t yet have the perfect device,” said Dr. Marc Semigran, medical director of Massachusetts General Hospital’s Heart Failure and Cardiac Transplant Program. “We and industry are working on developing devices that are smaller and . . . both more reliability and require less in terms of additional medication.”

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Erica Shea misses going to the beach and gets annoyed when the wire connecting her body to her battery pack gets caught on a doorknob, but she is grateful for every day with her son, Ryder.

When Ryder was an infant, she wrote a letter and placed it in the back of his baby book in case she wasn’t around to see him grow up. Now she is listed as top-priority for a heart transplant and is looking forward to a future with her family.

She and her husband hope that a donor heart will come soon enough that they can visit the island of St. John, in the US Virgin Islands, for their anniversary next September. “We need a vacation,” she said.


Jeremy C. Fox can be reached at jeremy.fox@globe.com. Follow him on Twitter @jeremycfox.