Not long ago, Beth Israel Deaconess Medical Center (BIDMC) heart patient Mirella Ursino feared her days of cooking, shopping, and, most importantly, enjoying her family, were numbered. Today, however, thanks to a remarkable medical journey, she still cooks a mean chicken parm from her Revere kitchen.
The 62-year-old wife, mother of three, grandmother of four and native of Revere, recently became the recipient of a Left Ventricular Assist Device (LVAD) at BIDMCâ€™s CardioVascular Institute. LVADs are implantable pumps that help weakened hearts maintain ample blood flow, thus prolonging lives. For many patients, these devices are a â€œbridgeâ€ to heart transplants.
BIDMC is the first non-heart transplant hospital in Boston to offer LVADs, reflecting a trend toward these devices becoming long-term â€œdestinationâ€ therapy for patients who are not good candidates for transplants.
Ursino regards cardiologist Robb D. Kociol, MD, director of BIDMCâ€™s VAD program, as her â€œlifesaver,â€ because he prescribed the procedure when she thought she had run out of options. She said she now considers Dr. Kociol and the BIDMC heart team to be among her â€œextended family.â€ That team includes Surgical Director Kamal R. Khabbaz, MD, who performed the LVAD implant, her original BIDMC cardiologist, Panos Papageorgiou, MD, and â€œthe caring nurses who are always there for me.â€
All in the Family
At the time Ursino was diagnosed with heart disease, she was not aware of any prior history in her family. In 1998, after experiencing shortness of breath and palpitations, Ursino was diagnosed with cardiomyopathy (weakened heart muscles). Over the next 14 years, there were alternating periods of stability and heart agitation, but she still enjoyed being with her kids and four grandchildren, all of whom either live with her or close by.
Fast forward to the summer of 2012, which Ursinoâ€™s daughters, Laura and Danielle Ursino, described as â€œthe worst time of our lives.â€ The Ursinos became increasingly concerned when their mom started losing weight and complaining about stomach distress and fatigue. Finally, in June, Ursino went to BIDMCâ€™s Emergency Room, where doctors determined that her blood pressure was dangerously low. Dr. Kociol then examined Ursino and put her on inotropes (intravenous medication that improves the heartâ€™s pumping ability).
Ursino was admitted to BIDMC, stayed for a couple of weeks, and was slowly weaned off the IV medicine. Upon discharge, she went home and started taking heart meds and diuretics. She also went for an evaluation at Tufts Medical Center to see if she was a good candidate for a heart transplant. After many tests, she was put on the transplant list but was told that she might have to wait a long time.
Two months later, in August, Ursino was nauseous, had little appetite, and couldnâ€™t perform her favorite activities: cooking and shopping. She was readmitted at BIDMC, where she again saw Dr. Kociol. The family, feeling very anxious, knew they needed another treatment optionâ€”fast.
A Big (Ventricular) Assist
The answer was LVAD intervention.
Dr. Kociol explained that LVADs consist of three components: a surgically implanted pump (the state-of-the-art HeartMate II manufactured by Thoratec), an electronic controller with batteries, and a strap for carrying the computer over the shoulder or around the waist.
Before the procedure, Dr. Kociol and the medical team trained Ursino and her daughters on the proper use and maintenance of the LVAD mechanisms, and prepped them for the operation.
â€œThe procedure went smoothly, and the recovery in the ICU was a relatively fast five days,â€ says Dr. Khabbaz.
After two weeks in the hospital, Ursino was discharged with her new heart-assist pump in tow.
Back in the Kitchen
Quickly, Ursino got back to her routine, making her own tomato sauce and cooking her signature dishes at home. She was also happy to resume shopping in the mall.
â€œAt first, I was a little uncomfortable carrying the computer box around with me, but you get used to it, and I hide it in my pocketbook, so nobody knows!â€ she said. â€œIâ€™m getting stronger and have more energy these days. Most of all, Iâ€™m so happy to go for walks and play with my grandchildren, who are my life.â€
Ursino is grateful that her family continues to support her, including taking her to regular check-ups at BIDMC.
â€œI look forward to seeing my lifesavers at the hospital,â€ she said. â€œThat Dr. Kociol, what a wonderful man â€¦he gave me his cell phone number and even calls me when heâ€™s on vacation!â€
Said Dr. Kociol, â€œMirella is doing really well and has a much-improved quality of life. Sheâ€™s still waiting for a heart transplant, but this has been a very successful bridge.â€
Looking ahead, Ursino has no big plans for changing her lifestyle.
â€œWhy do I need to travel when I get so much joy from my family at home?â€ she asked.
For the Ursino family, home is where there heart is.