The math is simple yet painful: Some 600,000 people in the United States have end-stage heart failure, the most severe form of the disease, but each year less than 1 percent receive a life-saving heart transplant. While the nationwide shortage of donor organs helps explain the sad statistic, so does the fact that many patients with the life-threatening condition are too sick and at too high a risk to receive a transplant.
But for some, like Sal Cangialosi, 75, a retired construction worker from Franklin Square, New York, there is another option: a left ventricular assist device, or LVAD, a battery-operated mechanical pump that helps the heart deliver oxygen-rich blood to the rest of the body.
On March 23, Cangialosi, who was experiencing severe shortness of breath, even at rest, became the first patient to be implanted with an LVAD at NYU Langone Hospital—Long Island. The four-hour procedure was performed by cardiothoracic surgeon Sunil Abrol, MD, the hospital’s director of the Mechanical Circulatory Assist and LVAD Program, and Nader Moazami, MD, professor of cardiothoracic surgery and chief of heart and lung transplantation and mechanical circulatory support at NYU Langone Health.
After placing the patient on a heart–lung machine, the surgeons, using real-time imaging for guidance, implanted the device just below the heart and attached tubes to the left ventricle and the body’s main artery, the aorta. Then they connected a cable to the external controller and power source, worn by the patient on a belt. Once activated, the LVAD began suctioning blood from the left ventricle and delivering it to the aorta, thus lightening the load on the overburdened heart.
Cangialosi was discharged nine days later, spent a week at NYU Langone’s Rusk Rehabilitation, and then returned home. By early May he was back to gardening and taking walks with his wife, Mary. Another patient received an LVAD in April, and many more implants are planned at the hospital. “Patients with advanced heart failure have a life expectancy of less than one year,” says Dr. Abrol. “On average, this device adds five years of life and, just as important, provides a higher quality of life.”
To Shaline D. Rao, MD, director of the Heart Failure Advanced Care Center at NYU Langone Hospital—Long Island, the milestone represents the natural expansion of a program ranked among the top hospitals in the country for cardiology and heart surgery by U.S. News & World Report. Long Island patients with heart failure now have access to the life-extending device at a convenient location. Those patients for whom an LVAD serves as a temporary bridge to transplantation can now get the bulk of their before-and-after care in Mineola while receiving a new heart once a match is confirmed at the NYU Langone Transplant Institute, named the nation’s top heart transplant program based on data from the Scientific Registry of Transplant Recipients.
“A lot of these patients are frail, and traveling to the city is burdensome for them and their family,” says Dr. Rao. “The launch of the LVAD Program on Long Island gives them access to complex heart failure care close to home.”