Device keeps hearts beating

FARGO - Michael Gunther's heart was so badly damaged, his fatigue so consuming, that he believes he once had just days to live. "I couldn't even finish a sentence," he says. His doctors concluded, in fact, that he wouldn't survive waiting for a t...

FARGO - Michael Gunther's heart was so badly damaged, his fatigue so consuming, that he believes he once had just days to live.

"I couldn't even finish a sentence," he says.

His doctors concluded, in fact, that he wouldn't survive waiting for a transplanted heart.

So surgeons implanted a device in Gunther's chest to help his weak heart pump blood; his circulatory system is now mechanical, governed by a small computer that he wears on his waist.

At age 49, the former electricity lineman is living with advanced heart failure with the aid of what's called a left ventricular assist device - a battery-powered pump.


He's one of a very small number of heart failure patients whose condition is so severe that it requires the pump, a device that alters the patient's life in many ways in order to save it.

The great majority of heart failure patients can be treated successfully through medication, restricting diet and salt intake, or even the use of a pacemaker or defibrillator, said Dr. Heeraimangalore Manjunath, a cardiologist at Sanford Medical Center.

"LVAD" - left ventricular assist device - "is a last resort," he said.

The life-saving devices impose serious restrictions and can result in complications including infection and bleeding.

Still, Munjunath recently received advanced training at Mayo Clinic to manage patients with advanced heart failure, including those with the assist devices or those who are candidates for a transplant.

For a variety of reasons, including ailments that accompany the aging population, long-term hypertension, and damage from a heart attack, more and more people are living with heart failure.

In Gunther's case, a massive heart attack at age 35 damaged his heart, a mishap he suffered moments after he climbed down from a utility pole when he finished installing a new power transformer.

At first, he shrugged his chest pains off as a pulled muscle; after all, that transformer weighed 230 pounds. But the pain intensified, and half an hour later, he was in the emergency room being treated for a heart attack.


Gunther had to quit his job as a lineman and turned to farming. Then, four years ago, he got a serious infection, which triggered diabetes, aggravating his heart condition so much that he became disabled.

"The heart just went downhill fast," Gunther said.

His doctors tried to adjust his medications, but nothing worked. Finally, last fall, his name was placed on a heart transplant list last fall.

"I guess I'm right towards the top," he said.

The pump has meant drastic changes in Gunther's lifestyle. He had to give up fishing and water sports because the computer can't get wet. He even had to give up flying his ultralight aircraft, which gave him a soaring sense of freedom.

His life depends on rechargeable batteries or being near a wall socket. With spares, he figures his batteries would last 2½ days in the event of a prolonged power failure. He was told he would survive about two minutes if his assist device stopped pumping.

But Gunther's not complaining.

"I felt so good after I got this," he said, referring to the pump that rests inside his rib cage, above his diaphragm. "It's not too bad to live with."


Because more and more people are living longer with advanced heart failure, managing their conditions is becoming increasingly complex.

In light of that, and because of the increased volume of patients, Manjunath and a Sanford cardiologist colleague in Sioux Falls received advanced training - making them two among 200 doctors in the nation to be board-certified in caring for advanced heart failure.

"It is a significant upgrade of our heart failure clinic," Manjunath said, noting that a team of cardiologists, nurse practitioners and nurses are involved in consultation with each patient's primary care doctor.

Now, instead of going to the University of Minnesota or the Mayo Clinic, heart failure patients with left ventricular assist devices can have many of their follow-up visits in Fargo.

For those who are not candidates for a heart transplant, the devices are a "destination treatment." Although experience with the gadgets is still relatively new - Gunther knows of a patient who has had one for 6½years - and it isn't known how long patients can tolerate them.

But, Manjunath said, the technology keeps improving. "It's still a developing field," he said.

As for Gunther, he joined his family at Minnesota's Twin Lakes for the July Fourth holiday weekend. He wasn't able to dangle a lure in the water, but that's OK.

"You still get that cool breeze, all the people around," he said.


Readers can reach Forum reporter Patrick Springer at (701) 241-5522

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