Javier Valencia blew out the candle on his birthday cake Monday but instead of simply celebrating another year he thanked his medical team for choosing him as their pioneering patient: He is the first to be implanted in Nassau County with a lifesaving LVAD — a device that pumps for a heart too weak to do so on its own.
The surgery, performed at St. Francis Hospital more than a week ago, marked yet another Long Island institution embarking on a technological path that rescues patients from severe forms of congestive heart failure. Stony Brook University Hospital has been implanting the electronic pumps — known more formally as a left ventricular assist device — for years. The Northwell Health System is planning an LVAD program in the not-too-distant future.
LVADs are implanted in patients for whom medications have failed. The mechanical device assumes the pumping duties that a weakened heart can no longer perform.
“I am alive,” Valencia of Bethpage said late Monday. “I am alive.” His 55th birthday was Sunday.
His words, celebrating survival, brought tears to the eyes of his wife, Jessica, whose birthday was Monday. “My husband has a new lease on life and that’s something we didn’t think he would have,” she said.
Valencia had seen a veritable conga line of doctors over the years, none of whom had effectively diagnosed him. They realized he had heart failure, said surgeon Dr. Edward Lundy, director of the Kroll Family Center For Heart Failure and Circulatory Support at St. Francis — but no one knew why.
Not until Valencia suffered a stroke last year while in a Long Island Railroad car and his medical care shifted to St. Francis, was the insidious reason uncovered.
Medical experts at St. Francis traced the accountant’s heart failure to Chagas disease, a parasitic infection caused by the bite of an insect called the triatomine bug. The insect is common throughout Latin America where it is known as vinchuca or chipo. Most people simply call it the kissing bug, carrier of the protozoan known as Trypanosoma cruzi. The insect not only bites, it defecates on its victims. The minuscule parasites are contained in the bugs’ feces.
Valencia was born in Ecuador, where he lived until his mid-teens. The parasite had quietly — irreversibly — damaged his heart.
Lundy said his patient has been placed on the list for a heart transplant.
“For patients like Mr. Valencia, the LVAD is a bridge to transplant,” the surgeon said, which means that patients remain on the pump until a matching organ is found. “There are some people who receive an LVAD as destination therapy,” Lundy said, noting that these patients’ hearts are driven by LVADs for the rest of their lives.
Lundy, who also holds a doctorate in physiology, said patients implanted with LVADs no longer have heart beats that can be detected through a stethoscope. The familiar lub-dub heart sound is gone.
“Normally, the heart squeezes and relaxes,” Lundy said. “But with an LVAD there is a continuous flow.”
The device, he said, is equipped with a portable power pack that allows mobility.
Dr. Hal Skopicki, director of the heart failure program at Stony Brook University Hospital, said his institution has already implanted 57 LVADs.
“I am ecstatic that such lifesaving technology will now be widely applied to a larger patient group that needs these kinds of therapies. Too often we get caught up in the competition among health systems.”
He added that patients have to steel their nerves as they wait for a transplant.
“We had a patient on the mechanical device for 5 1⁄2 years,” Skopicki said. “The average wait time is anywhere from two to five years.”
Valencia, meanwhile, is scheduled to be discharged on Thursday.
“I am so happy,” his Jessica Valencia said. “He’s not out of breath any more.”