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A patient is surrounded by his care team.

An elite club: 10 years with a ventricular assist device

After 10 years of living with a special device that helps the heart pump blood, one pediatric patient is part of an elite group of survivors.

Edgar Arredondo was 15 when he had a ventricular assist device implanted in his chest to keep his blood pumping after a muscular disease weakened his heart. 

In children, mechanical heart pumps typically serve as a bridge to heart transplant, allowing patients with failing hearts to leave the hospital until a donor is found. But Arredondo, now 26, never had a transplant. Instead, he recently celebrated 10 years of living with the device -- a rare milestone -- and doctors say he's going strong despite having recently contracted COVID-19.

"I never thought I'd get this far and live so many years with a VAD. It's easy and hard at the same time," Arrendondo said in a Stanford Children's Health article.

Arrendondo is in an elite club. He has lived with a ventricular assist device for far longer than any of Stanford's other pediatric heart patients and longer than most adult patients worldwide. Of 27,000 adult recipients around the world who have the device, just 370 have lived with it more than 10 years.

Implanted in an open-heart surgery, ventricular assist devices contain a motorized pump. Attached to the heart's left ventricle, it continually pushes blood through the heart and back into the body. A cable inserted through the patient's abdomen connects the pump to a wearable controller, battery pack and power cord outside the body.

Caring for your heart (pump)

When Arrendondo received his first implanted device -- called the HeartMate II -- at Lucile Packard Children's Hospital Stanford in 2010, many children's hospitals hadn't attempted the procedure because almost all ventricular assist devices are designed for adults. 

A patient celebrates his birthday with two cakes.
Edgar Arredondo has had a ventricular assist device attached to his heart for 10 years. (Courtesy of Arredondo)

In 2018, he received the newest version, HeartMate 3, which maintains better blood flow and results in fewer complications. 

Living with a mechanical heart pump requires a lot of care. The patient must carry the cord, controller and extra batteries wherever they go; keep their entrance site clean; and alert their care team whenever something doesn't feel right.

Since clotted blood can clog the pump, Arrendondo's care team must balance anticoagulation medicines with blood thinners to keep his blood flowing. He has avoided a hospital stay since 2018, even when he contracted COVID-19.

Although patients with ventricular assist devices are susceptible to pump malfunctions, strokes and infections, Arrendondo recovered from COVID-19 without the need for supplemental oxygen or hospital support. He credits his family with helping him stay healthy.

Superhuman

Arrendondo, who enjoys attending church, eating healthy meals with his family, drawing, and playing video games, marked five years on a ventricular assist device with a celebration in the courtyard at Lucile Packard. He celebrated his 10-year anniversary with his parents and sisters and he hopes to celebrate with his doctors and nurses once the dangers of COVID-19 pass. 

"Edgar's outlook is what makes him superhuman. For most people, living with a VAD would take a bigger mental toll," said pediatric cardiologist John Dykes, MD, medical director for the ventricular assist device program at Betty Irene Moore Children's Heart Center. "His willingness to calmly keep going no matter what, along with his family's incredible support, is really remarkable."

Top photo by Norbert von der Groeben shows Edgar Arredondo surrounded by his care Betty Irene Moore Children's Heart Center care team, his parents and his sisters when he celebrated being on a ventricular assist device for five years.

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