His heart belonged to the mountains, but then 17-year-old Jovit Garcia suddenly felt his heart heading somewhere else, changing his life forever. Aside from looking pallid and experiencing shortness of breath, he also felt easily exhausted while hiking despite having climbed mountains before, prompting him to take action.
“I used to be in a mountaineering club when I was in college and I noticed then that when I made even a little effort climbing, I get extremely tired. That was when I finally went to have a checkup,” says Jovit, who is now 32 years old and a father of two.
He went to the Cardiology Department of Makati Medical Center (MakatiMed), the country’s leading hospital for world-class healthcare, to consult with heart specialists. Jovit was then diagnosed with dilated cardiomyopathy, a condition where the heart cannot pump blood due to the swelling and weakness of the left ventricle, the heart’s main pumping chamber. His grandparents were also once diagnosed with the same condition. But those without any genetic history of heart failure could still get dilated cardiomyopathy through viral infections that could inflame the heart muscle. Other causes include ischemia, drugs, or alcohol.
Jovit gave up his active hobbies and often stayed resting in his room. He also had a brush with death, surviving a cardiac arrest in his mid-20s. His attending physician, Cardiac Electrophysiologist Anthony B. King, Jr. MD said Jovit eventually had to be inserted with a Cardiac Resynchronization Therapy – Defibrillator (CRT-D) to improve his heart functions, but it wasn’t enough. “After four, five years, his health started to deteriorate despite the interventions,” Dr. King adds.
Learning about LVAD. Lyne Garcia, Jovit’s wife, shared that he had long researched online regarding options that could assist his heart. Among these options include the Left Ventricular Assist Device (LVAD) implant. So, when Dr. King recommended this to Jovit when he was hospitalized in May 2021, he and his family were more than ready to have the device implanted on his heart. “Jovit has always wanted to have a mechanical heart because he wants to live longer. He wants to see our kids grow up,” Lyne says.
An LVAD procedure is done by surgically implanting the device on the bottom part of the heart which will help boost the heart’s blood pumping activity. The device is connected to another device located outside of the patient’s body, which acts as the controller. The LVAD is initially used as a bridge therapy to heart transplantation. To date, this device could last up to a period of 10 to 15 years.
Cardiologist-Intensivist Oliver M. Sansano, MD explained that heart failure is a progressive disease: once a patient is no longer responding to conservative measures and is reaching an end stage of heart disease with compromise to other major organs, then the patient is a candidate for heart transplantation. Dr. Sansano further mentioned that, unfortunately, heart transplant is not available in the Philippines because even in countries that do have it, it is usually difficult to find a compatible heart. Therefore, the use of mechanical circulatory support devices like the LVAD is an internationally acceptable therapy to first, bridge to recovery; second, bridge to heart transplantation; and third, serve as a destination therapy, which is the final therapy for advanced or end stage heart failure.
“The LVAD is described as a scaled down version of a jet engine attached to the apex of the left ventricle, and the outflow graft conduit is attached to the ascending aorta. The LVAD pumps blood from the weakened left ventricle to the aorta. This is powered by two portable external batteries that provide 12 to 14 hours support,” Dr. Sansano explains. Jovit was screened for indications and probable contraindications, and was then deemed as a “good candidate” for LVAD implantation.
LVAD procedure and post-op care. During the LVAD pre-operational assessment, Cardiothoracic Surgeon Ramon I. Diaz, Jr. MD who led Jovit’s LVAD procedure, says the patient’s heart was already enlarged and stiff, making him a candidate for the device. He was also screened for contraindications, possible heart-related damage in other organs, right ventricular function, and other tests. After the LVAD was implanted in June 2021, Dr. Diaz already noticed a change in Jovit’s heart functions. “Right off the bat, Jovit was doing very well. All indications were that the LVAD really benefited him from the start,” he says.
Nursing care is also a crucial part of every LVAD patient’s full recovery. They require close monitoring post-surgery to evaluate if their heart and the device are working well together by running multiple tests like echocardiograms and chest X-rays. Even their diet is carefully planned to ensure they’re getting proper nutrition.
MakatiMed’s cardio experts say LVAD patients must observe careful maintenance during their day-to-day lives. Nurses or caregivers at home are expected to help patients manage the LVAD and perform regular device care and system checks including battery changes, daily self-tests, and driveline dressing monitoring. They also provide further medical assistance in managing daily medications and common complications like infections, hemorrhage, and device thrombosis. One should put off activities such as swimming and taking baths must be done with diligence to avoid the device from getting wet. Eating a healthy and balanced diet also is crucial in keeping the LVAD patient healthy.
Even with these things in place, Dr. Sansano says LVAD has allowed patients to perform activities they weren’t able to do before the procedure. Just a few weeks after the procedure, Jovit could lift dumbbells, exercise on the stationary bike, and climb up and down the stairs. Dr. Sansano says slowly but surely after the LVAD, they are helping Jovit eventually reduce his limitations in other activities by putting focus on strengthening of Jovit’s skeletal muscles.
Jovit is a testament that people with heart problems can still improve their quality of life. Luckily, he immediately sought medical help at the first signs of a heart problem, underlining the importance of early detection in battling this disease. The MakatiMed cardiologists say feeling exhaustion and fatigue while performing usual tasks or activities should be considered as a red flag and prompt a person to consult with a doctor immediately. In some cases, the first symptom would be a cardiac arrest where chances of survival are slim.
Now with LVAD to help his heart perform better, Jovit feels more optimistic of the future, hoping to extend their family of four and have another child. As his wife adds, the couple hopes that Jovit’s journey will serve as a reminder to everyone that heart failure isn’t a dead end. “I want to inspire because I know there are many who have heart ailments who feel there are no other solutions,” Lyne says with a smile. “There is life with LVAD.”
For more information, please contact MakatiMed On-Call at +632.8888 8999, email mmc@makatimed.net.ph,or visit www.makatimed.net.ph.
This is a press release distributed by CASTRO Communications