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LVAD saves — and improves quality of — patient’s life

Certified Nurse Practitioner, Jessica Tvedt and patient, Steve Miller.
Certified Nurse Practitioner, Jessica Tvedt and patient, Steve Miller.

Steve Miller has been a patient at Monument Health for a long time — he began seeing Cardiologist John Heilman III, M.D., FACC, in 2015 when he experienced his first signs of heart trouble. He spent some time in the hospital, but with the right medication he bounced back. When he experienced additional troubles in 2016, Dr. Heilman implanted a pacemaker, which resolved the problem at the time.

“Then last winter I noticed I was getting short of breath, and I went to the hospital in March, and Dr. Tuma installed a mitral valve clip,” said Steve.

“Steve has dilated cardiomyopathy with end stage biventricular heart failure and mitral valve regurgitation. Dilated cardiomyopathy is a condition of the heart muscle that causes the heart chambers to thin and stretch resulting in an enlarged heart. This makes it hard for the heart to pump blood to the rest of the body,” explained Jessica Tvedt, CNP. “The cardiomyopathy resulted in end-stage biventricular heart failure, which is a combination of both left-sided and right-sided heart failure. He also had severe mitral valve regurgitation, which is when blood flows backward through the valve.The transcatheter mitral valve repair using a MitraClip done by Dr. Tuma was intended to rectify that particular problem.”

“That really helped for about three months,” said Steve. “And then about July, I started noticing I was getting really short of breath again.” Steve couldn’t sleep because of the breathing trouble and he also lost his appetite, leaving him in poor shape.

Jessica and Steve were both frustrated that Steve didn’t seem to be making progress, despite efforts to improve his breathing. “He was seen in the heart failure clinic several times, and many times there were limited treatments we could do for him given his low blood pressure, fatigue and kidney dysfunction.” Eventually, Dr. Heilman admitted Steve to the hospital and reviewed the limited options with him, the best of which was getting an LVAD implant.

An LVAD, or left ventricular assist device is essentially a pump that is installed in the heart which helps the left ventricle pump blood throughout the body. LVADs are primarily used in patients who have reached end-stage heart failure. Dr. Heilman arranged a trip to Mayo Clinic via Life Flight, and following a week of tests, Steve had his LVAD surgery.

After a total of five week’s at Mayo, Steve returned home, but he still had some recovery to do. “I’m still not at 100 percent, but I’m getting stronger all the time. For me it has absolutely been worth it,” Steve said. “First of all, I’m alive! Just as importantly, my quality of life has really improved. I can breathe, I’m eating well, and overall I feel really good.”

Now that he’s back in the Black Hills, Steve’s primary cardiac care is with Jessica, who works with a number of patients with congestive heart failure, and Dr. Heilman. “Steve is a very pleasant and compliant patient and has done remarkably well following his LVAD implant,” said Jessica. “His wife, Donna, has been a great advocate for Steve and is one of the best record keepers!”

The LVAD could provide Steve with an additional seven to 13 years of life, and he’s happy to not only have the time, but also an improved quality of life.

“I’m thankful for the experience at Mayo and for my care at Monument Health,” Steve said. “I also am so grateful that Dr. Heilman was so thorough, and that I can put my trust in Jessica to manage my medicine and care. They are phenomenal.”

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