Patient’s severe heart failure leads to LVAD surgery and a new lease on life

Scott McCoy, 54, who suffered a heart attack and progressive deterioration to severe end-stage heart disease, is enjoying life now - even mountain biking - after undergoing an implant of a left ventricle assist (LVAD) device at Emory University Hospital.McCoy on his bike

Heart attack was not a word in Scott McCoy's vocabulary until October 1, 2006. Before that time McCoy ate well, worked out four days a week, enjoyed advanced level kayaking, guided whitewater rafting trips on weekends and had a successful career in public health. However, at the age of 54, according to McCoy, an extended history of heart disease in his family and periodic smoking for 30 years caught up with him.

Early one Sunday morning McCoy recalls feeling fatigued, congested, and nauseated. He noticed that his skin color was ashen, and thought that he was coming down with the flu. In a very short time, his nausea intensified and diarrhea ensued. An hour later, he experienced a severe crushing pain in his chest. According to McCoy, a friend dialed 911 and he was taken to a local hospital where he underwent life saving measures and had one or more stents implanted into his coronary arteries to restore blood flow to his heart. One week later, his condition suddenly took a turn for the worse and he underwent urgent triple coronary artery bypass surgery. McCoy survived surgery and a very long recovery period in December 2006. In January 2007, new problems with his heart were identified and he underwent a pacemaker/defibrillator implant. He was diagnosed with congestive heart failure and his condition further declined over the next several months. He recalls having very little energy, experiencing difficulty breathing, difficulty sleeping, having repeated build-up of fluid in his body and frequent hospital admissions during that time.

It had been 15 months since the initial heart attack that launched this series of events and McCoy definitely wanted a change. "We had exhausted all treatment options up to that point," says McCoy. "Fortunately, my cardiologist knew of the left ventricular assist device (LVAD) studies being conducted at Emory University Hospital, and I was admitted to Emory for evaluation."

An LVAD is a blood pump that assists the left side of the heart with pumping blood to the rest of the body and is used in some patients with advanced heart failure. LVADs have been widely used as a bridge to transplant to help patients survive while waiting for heart transplantation. More recently, LVADs have been designed for more long-term use, or "Destination Therapy." Emory is one of the major medical centers participating in device studies for "Destination Therapy." These newer devices are implanted inside the body, and are relatively smaller and lighter than earlier LVAD models.

"Emory University Hospital is the only hospital in the state of Georgia that can offer this cutting edge, lifesaving technology to this patient population," says cardiothoracic surgeon, J. David Vega, MD, associate professor of surgery and director of the Heart Transplant Program at Emory University Hospital.

In February 2008, McCoy underwent surgery for an LVAD implant by Dr. Vega, and began a new chapter in his life. By May, 2008, McCoy noticed that he was feeling really good again, and has continued to improve every since.

"I can't function at the level I did before I had the heart attack, but I feel so much better," he says. "I adhere to a physical therapy routine prescribed by the team at Emory. My muscle tone has returned and light weight workouts at the gym and walking are part of my daily routine. I can't do single track bumps on a mountain bike but I have been able to work my way up to short, easy trips on a smooth grade. At least I can be outdoors. I can also hike. I never thought I would feel good again. Life is good and it's good to be alive. I don't think I would have survived a lot longer if I hadn't had the surgery."

"Anyone considering the surgery needs to plan out their support network prior to the surgery," says McCoy. "It's not something I did on my own. The medical care I received at Emory was outstanding. It was great to have teams of people who covered so many topics so thoroughly, including nutrition and possibility of infection. Everyone had time for me. But I give a lot of credit to the love and support of my family and friends, who learned how to do the daily dressing changes required to prevent infection at the drive line site and to change and recharge the batteries that supply power to the pump. You really need a lot of emotional support." After a month-long hospital stay recuperating from the surgery, McCoy returned home well-prepared to maintain the LVAD equipment and begin life with the device.

"Mr. McCoy told me (after the fact) that he would kneel at his bedside in order to breathe," says Andrew Smith, MD, associate professor of Medicine and medical director of Emory's Heart Failure and Transplant Program. "It is hard to comprehend the distress he was going through. He was not one to complain. The LVAD pump has required careful attention on his part but has made a huge difference in his quality of life, not to mention his survival. In my 20 years of caring for patients with heart failure, the treatment options continue to improve. It is gratifying work and one that requires teamwork."

For more information, contact Andrew Smith, MD or S. Raja Laskar, MD at 404-778-5273.