Advanced heart failure: a worse prognosis than most cancers today
5 minutes read
- The life expectancy of a heart transplant recipient exceeds 10 years.
Santo Domingo.-Heart disease is the most common cause of death in people over 40. To prevent it, it is important to eat a healthy diet, exercise often, not smoke and have a general check-up every 1 or 2 years, says Dr. Nicolás Brozzi of Cleveland Clinic, who led the transplant of Dominican patient Abelardo Alexander De la Cruz Vargas.
After a hard battle with this high-risk heart condition, De la Cruz Vargas successfully received a heart transplant at Cleveland Clinic Florida, thanks to early intervention by his primary doctors in the Dominican Republic and his referral to this US health centre.
“Congestive heart failure can have multiple causes affecting the heart muscle, valves or arteries. Often the causes are clear, as in the case of a major heart attack or an infection of a valve or the heart muscle, while in half of cases the cause is not so evident; these are called idiopathic, and there may be genetic and hereditary components and even environmental factors that are still being researched,” explains Dr. Brozzi.
He also adds “that advanced heart failure has a worse prognosis than most cancers today. Patients have a life expectancy of 5 years. If they suffer acute decompensation, as in Abelardo Alexander’s case, the chances of surviving a year are less than 20%.
De la Cruz Vargas was referred for a second opinion by his Dominican medical team. “I arrived at the hospital with acute decompensated congestive heart failure, was stabilised in the ICU and then received a heart transplant. Given the situation, we didn’t think twice, and because of the hospital’s prestige and my insurer’s advice, we completed the necessary paperwork to be admitted to the clinic,” says the patient.
“When a patient is referred to Cleveland Clinic, we follow a protocol before proceeding with their care. Patients bring previous tests carried out at other hospitals, or clinic staff contact the patient’s primary doctors to obtain the best possible information. This always makes the initial assessment easier, and further tests depend on the particular clinical situation of each case.
In this particular case, Cleveland Clinic doctors determined that the most viable way to save his life was a heart transplant. “When a patient is in advanced stages of heart failure, we recommend heart replacement therapies, which can be carried out with mechanical pumps implanted in the patient’s chest or with a heart transplant, the treatment that offers the best long-term survival,” the specialist explains.
“With faith in God, the support of my wife, the prayers of my family, friends and acquaintances, and the certainty that God was working through the medical team, given the good care I felt at every moment. The explanations from each person who was going to carry out a procedure made me feel safe,” says De la Cruz Vargas, adding that everything came together for events to turn out positively.
“Life expectancy after a heart transplant has been improving over the years, and today more than half of patients are alive more than 13 years after receiving their new heart. That’s an interesting contrast when you consider that more than half of these patients would have died in less than a year without that new heart,” adds Brozzi.
He stresses that “follow-up after a heart transplant is very intense, requiring frequent blood tests and other studies. The clinical team adjusts medications after the transplant according to the patient’s clinical condition and the results of these tests. Frequent team discussion again plays an important role in this stage of recovery.”
“In the early period after heart transplant surgery, care is similar to other heart surgeries, including wound care, progressive physical activity and physical rehabilitation. Medical treatment is aimed at avoiding organ rejection and preventing infections. Long-term care depends on the patient taking their medication consistently and attending medical follow-ups as instructed.”
“I see life differently. My first goal is to complete my medical process well and gradually make changes in my life that bring me more and more peace and calm, settle pending family matters and so on, asking God to give me the chance to know his purpose for me and the strength to fulfil it,” says Abelardo Alexander.
A world-class medical centre
“The privilege of leading the treatment of heart disease is due to hard teamwork over the years, since the development of coronary bypass surgery by Argentine surgeon Dr. Rene Favaloro in 1967. The team’s experience is essential to achieving good results, and Cleveland Clinic has performed more than 170 heart transplants in the last 6 years. Our professionals’ dedication is reflected in the national quality of care rankings, placing us among the country’s top 4 programmes,” said Brozzi.
Cleveland Clinic doctors are guided by three essential pillars that express the hospital’s mission: dedication to caring for life, research, and education of medical staff. This creates a dedication to patient care, with patients always at the centre.
The concept of a patient-centred “multidisciplinary medical team” is fundamental to assessing and treating complex diseases. Each specialist brings their view of the problem, making it easier to understand each patient’s problem as a whole, reducing repeat test orders, optimising each patient’s medical assessment time and facilitating their treatment.
“At Cleveland Clinic we have everything needed to carry out a complete assessment of patients and offer them the treatment they need, as in the case of patient De la Cruz, who was admitted in cardiogenic shock and needed a temporary device implanted to stabilise him before the heart transplant could be performed.”
About Cleveland Clinic
Cleveland Clinic is a century-old health centre that remains a leader in the region. It has spent 100 years caring for all kinds of patients. Thousands of people from the Dominican Republic seeking hope in critical cases have seen this international health centre as their last option to regain their health.