Ten years ago, Caldwell County resident Ronald Breaux was an avid fisherman, hunter and gardener. Then he was diagnosed with congestive heart failure and told that his only option for survival was a heart transplant.

Finding a donor match proved to be more challenging than he had hoped. To make matters worse, his condition deteriorated to the point that even his medications weren’t helping. The situation was beginning to seem hopeless.

“I was so weak I couldn’t even walk out of my house without being tired,” Breaux says. “I couldn’t do anything at all. I even had to let my garden go.”

Breaux is not alone. For patients who have been diagnosed with end-stage heart failure, transplantation has traditionally been the only option left open to them. For many like Breaux, the wait list for a donor heart is often too long. For others, their condition leaves them too weak to withstand the surgery, rendering them ineligible for a transplant.

But all of that changed the day Breaux received the HeartMate II, a ventricular assist device (VAD) implant, at Seton Medical Center Austin. The surgery gave him back something he was afraid he would never have again: his life.

VADs weren’t always so successful. When they were first introduced, they were large devices that required patients to be connected to very large power sources. Thus, patients were permanently confined to hospitals, rendering them immobile and the treatment expensive.

Thanks to advanced technology, these newer devices are much smaller, making the surgery less invasive. The HeartMate II acts as an artificial heart and is implanted into the patient’s chest. But instead of replacing the heart, it is connected to the heart.

Blood then enters the device from the left ventricle and is pumped into the ascending aorta, creating a continuous flow through the body. A cable attached to the device exits the body, where it connects to a battery-powered controller.

“What we explain to our patients is that it’s like a helper for the heart,” says Seton’s VAD Outreach Coordinator Erin August, RN, BSN. “It helps pump your blood whenever your heart becomes so sick and weak that it can’t do its job of pumping enough blood to the body.”

Since 2008, this newer, smaller VAD has been used in patients who are on a waiting list for a heart transplant. But in January of this year, the Federal Drug Administration (FDA) also approved its use for destination therapy (permanent use), an approach used for end-stage heart failure patients who are ineligible for a transplant due to age, additional health problems or other complications. The FDA’s decision brought newfound hope to those who may be ineligible for transplantation surgery, but choose to live with the VAD for the rest of their lives.

One of the most high-profile recipients of this device is former Vice President Dick Cheney. His highly publicized advanced-stage heart failure made him a candidate for VAD implantation, and he received his VAD implant in July.

While he might be the most well-known VAD patient, Cheney has one thing in common with the other patients who are candidates for the device, according to Dr. Eric Hoenicke, a cardiothoracic surgeon with Cardiothoracic and Vascular Surgeons in Austin.

“They’re patients [who] have heart failure or weakening of the heart muscle so severe that it’s really difficult for them to do even the simplest activity,” he says.

Because many of the devices themselves are only slightly bigger than a D-cell battery, the external power sources have shrunk considerably, as well. This allows patients mobility while concealing batteries in a small backpack, holster or a specially designed purse.

Patients can easily carry two batteries and the pump strapped to their bodies, so they’re mobile for everyday activities. Each battery generally lasts about 12 hours per charge. At night, patients plug into a constant power source.

Patients can do just about anything except submerge themselves in water—so no swimming or taking a bath. They can, however, fly in an aircraft, and some patients who have had the HeartMate II for an extended period of time may even drive a car. If they need to charge batteries while on the go, the VAD can be plugged into a car’s power source just like you would a cell phone.

The first and only continuous-flow device approved for both bridge-to-transplantation and destination therapy, the HeartMate II is designed for long-term support. Small and quiet, the implantable device is suitable even for smaller-framed patients.

With these newer devices, a VAD surgery will typically take a mere four to six hours from start to finish with a hospital stay of only 10 to 14 days.

Seton Medical Center Austin is one of only 120 hospitals in the United States certified to implant the HeartMate II. And of those, Seton is one of the 78 hospitals certified for destination therapy (DT), according to Thoratec, the device manufacturer. As such, it has had the privilege of being the first hospital to perform a DT implantation in Central Texas.

Dr. William Kessler, the cardiothoracic and vascular surgeon who performed that surgery in March, says with advances in technology and miniaturization, VADs are improving “about every six months. In the next 10 years, [they] will replace transplantation.”

The medical team at Seton Medical Center Austin goes literally above and beyond the call of duty. Seton is one of only a handful of hospitals nationwide with an on-staff transport team offering outreach care and training. Patients are airlifted from the referring care facility and flown to Seton for implantation. Led by August, the highly skilled six-member flight team is trained to care for these very ill patients during transport.

After the surgery and recovery, the patients can return to their hometown. The team at Seton travels home with them to offer outreach training to the referring physician, ER staff and other caregivers so patients can return to life in their homes surrounded by family, friends and community. The team also offers around-the-clock triage over the phone if the need arises.

As for 57-year-old Breaux, on the day his VAD was implanted in his body, hope was planted in his heart. He received the VAD implant, and his future changed. Less than two weeks after receiving his VAD at Seton, Breaux was able to get up and walk around without tiring. Today, he is back to his ranch, his family and his garden - and he hopes to go fishing very soon.

For more information about the Seton Family of Hospitals, visit www.seton.net.