Heart patient Frank DiBennedetto, 67, enjoyed his work as an inspector of finished products for a local phone company before health issues led to his retirement. DiBennedetto had always been independent and was frustrated when he experienced heart problems he couldn’t resolve by himself. But after medical procedures at BIDMC, he learned to embrace a new lifestyle with the assistance of his medical team at BIDMC’s CardioVascular Institute (CVI) and a Ventricular Assist Device (VAD).
The VAD, a surgically implanted heart pump, helps weakened hearts receive ample blood flow—and helps keep heart failure patients like DiBennedetto alive.
In 2015, DiBennedetto was on the waiting list for a heart transplant. His VAD was intended to serve as a “bridge” until a heart became available. When a new medical development ruled out a transplant, the bridge turned into “destination” therapy.
Today, thanks to the pump, DiBennedetto continues to climb the stairs to his second-floor apartment in Somerville, Mass., do errands, and enjoy spending time with his wife and friends. He even joined the BIDMC Heart Walk team (see photo, right, of DiBennedetto with his wife, Peggy, at the walk).
A Bridge to Transplant?
DiBennedetto remembers a time when he considered himself to be in generally good health “despite my beers.” However, there was a history of heart disease in his family—his mother had congestive heart failure, and he lost two uncles to heart disease.
In the 1990s, DiBennedetto experienced shortness of breath, and his symptoms gradually worsened. Over the years, he was diagnosed and treated for heart failure and a potentially life-threatening fast heart beat called ventricular tachycardia.
In January 2015, DiBennedetto was rushed to BIDMC with a high heart rate, low blood pressure, and shortness of breath. He was in cardiogenic shock—a condition in which the heart is suddenly unable to pump enough blood. A temporary Intraortic Balloon Pump device was inserted into his heart to increase blood flow, but DiBennetto’s heart remained weak.
He was referred to cardiologist Robb D. Kociol, MD, Director of BIDMC’s Advanced Heart Failure Program. Kociol advised DiBennedetto that he needed a heart transplant and a VAD to keep him healthy until a heart became available. A VAD is a mechanical heart pump.
One Step Forward …
In March, Kamal R. Khabbaz, MD, the CVI’s chief of cardiac surgery, performed VAD surgery on DiBenedetto.
The open heart surgery involved an incision through the breastbone, allowing the surgeon access to the heart place the VAD. The surgery, which takes approximately four-to-six hours, provides a pump to restore adequate blood flow to the body, supporting the native heart that cannot work effectively on its own.
According to Kociol, VADs consist of three components: a surgically implanted, state-of-the-art pump, an electronic controller with batteries and a strap for carrying the computer over the shoulder or around the waist.
After five days in the ICU and a total of two weeks in the hospital, DiBennedetto was discharged and started his recovery without needing rehab services. He adjusted to a new lifestyle in which battery maintenance and dressing changes were important parts of his daily routine.
DiBennedetto progressed well and made the necessary sacrifices, including no showering and no swimming. After testing at Tufts Medical Center—BIDMC’s transplant partner–he was hopeful a date soon would be set for a heart transplant. But recurring symptoms of heart failure brought him back to BIDMC for further evaluation and revealed a leaky aortic valve.
VAD as Destination Therapy
In December 2016, after Kociol reviewed DiBennedetto’s worsened condition, Khabbaz performed surgery to replace his aortic valve with an artificial valve. During the surgery, a CT scan revealed enlarged lymph nodes in his chest. A bone marrow biopsy rendered an unexpected diagnosis: DiBennedetto had leukemia, and no longer qualified for a heart transplant.
Fortunately, today the leukemia is under control and DiBennedetto has accepted that the VAD is now the best option for his heart. He goes for monthly cardiac checkups and periodic visits to BIDMC’s oncology clinic.
“He is a great role model for other patients,” says Cindy Cunningham, NP, who works closely with VAD patients. “The VAD team is here to promote patient independence and give reassurance. We develop a unique bond with these patients and their families, and we consider it a privilege to care for them.”
Kociol said, “Our program is designed to give patients like Frank the best chance to improve their quality of life. With the shortage of transplant hearts, VADs as destination therapy are becoming more common. It is unfortunate that not all heart failure patients qualify for a heart transplant. Fortunately, VADs keep them going.”
“I have nothing but praise for the wonderful care I received from Dr. Kociol and Cindy, who has been there from the get-go,” says the irrepressible Di Bennedetto. “Hey, I’m still driving, traveling to Florida…I’m still ticking.”