An update from Kelly C. McCants, M.D., medical director of the Norton Heart & Vascular Institute Advanced Heart Failure & Recovery Program and executive director of the Institute for Healthy Equity, a Part of Norton Healthcare

This has been a momentous year for Norton Heart & Vascular Institute’s Advanced Heart Failure & Recovery Program. We launched our left ventricular assist device (LVAD) program and received accreditation from DNV GL, which is recognized by the Centers for Medicare & Medicaid Services.

Launching an LVAD program has been a huge undertaking, especially during the COVID-19 pandemic, and required teamwork and collaboration throughout the entire Norton Healthcare system. Although starting an LVAD program here has been one of my personal primary goals since joining Norton Heart & Vascular Institute in 2018, we have a dedicated multidisciplinary LVAD team led by two outstanding cardiothoracic surgeons, Steven W. Etoch, M.D., and David H. Rosenbaum, M.D., in addition to a host of  advanced heart failure cardiology providers and staff who really are the backbone of this program.

For an LVAD patient to be successful, a fully engaged team of providers, pharmacists, nutritionists, therapists and social workers must provide crucial support along the way. Moreover, everyone who may interact with a patient during the hospital stay must have proper education and training so everyone understands what to do in an emergency situation. This requires an enormous amount of support from the entire hospital system — in particular, Norton Audubon Hospital and the entire team led by Anne Marie Holas-Dryps, system vice president for Norton Heart & Vascular Institute. 

Once considered primarily as a bridge to cardiac transplantation, LVAD as destination therapy has rivaled a heart transplant from a one-year and two-year survival standpoint approaching 90%, and is readily available given the lack of donor organs available for transplantation. The LVAD is implanted during an open heart procedure, which typically lasts four hours and requires a hospital stay of at least 14 days. Following surgery, specially trained cardiac nurses and LVAD coordinators monitor the patients’ postoperative course, focusing on safety and education of the family and caregivers prior to the patient returning home and resuming daily activities. Before and after surgery, advanced heart failure cardiologists like Bassel Alkhalil, M.D., and Srikanth Seethala, M.D., provide weekly and monthly care for our 10 LVAD patients successfully implanted during our inaugural year. The team also provides ongoing care and monitoring for an additional 11 LVAD patients who transferred into our program after their devices were implanted.

Our mission is to assist these patients along their heart failure journey, whether it is medical management of heart failure, providing mechanical circulatory support, or collaborating with established heart transplant programs like the University of Kentucky. Our goal is to provide excellent care close to home as we continue to build on our outstanding program that is fully accredited with a one-year survival of 100% thus far and has a length of hospital stay shorter than the benchmark national average.