Sid Tripp, 57, of Portland can stay active thanks to a portable mechanical pump that keeps his blood flowing while he awaits a heart transplant.
Sid Tripp refuses to give it a name, but it’s always connected to him, appearing at first glance to be a laptop bag hanging from a shoulder strap. If he were at a business event, and Tripp attends many as an advertising executive, no one would give it a second look.
But what’s in the not-to-be-named bag – and the tube that snakes from it into his body and up to his heart – is keeping Tripp alive.
The bag contains a left ventricular assist device – or LVAD – a battery-operated pump that helps the heart keep blood circulating through the body. The LVAD is for patients with advanced heart failure, those who would likely only have months to a year to live.
“I don’t want to give it a name, because it’s temporary,” said Tripp, 57, one of about 4,000 people in the U.S. on the heart transplant wait list. He’s hoping the LVAD is the bridge that gets him to a new heart.
About 2,200 heart transplants are performed annually in the United States, but some 300 people die each year while waiting for the procedure, according to the American Heart Association.
Maine Medical Center is the only hospital in northern New England where LVAD surgeries are performed, and it is expanding its capabilities to conduct the surgery, from five in 2016 to 16 in 2017 and 20 this year. Dr. Walter DeNino, a cardiac surgeon for Maine Med’s LVAD program, said the hospital hopes to double that number over five years. A $512 million hospital expansion scheduled to start this spring will help give the program the space it needs, he said.
“There is always a need. There will never be enough hearts to meet the demand,” DeNino said. “There is a dramatic improvement in quality of life (with LVADs). People are going golfing and skiing with them.”
DEVICE SIMULATES FAINT HEARTBEAT
“There is always a need” for the lifesaving surgical implants, said Dr. Walter DeNino, a cardiac surgeon for Maine Med’s LVAD program.
The first LVADs were developed in the 1960s and used only on patients who were recovering from heart surgeries and had to remain in the hospital, according to the heart association. The first LVADs that patients could take home took up so much space that they compressed the stomach and made it difficult to eat. The second and third generations of the portable devices have improved substantially, and there have been more than 20,000 patients implanted with LVADs since the early 2000s.
“They will soon be similar in size to a AA battery,” DeNino said of the pumps implanted in LVAD patients.
Tripp’s LVAD is quiet, with blinking monitors on the part inside the bag that display statistics vital to his survival. On a recent day, the monitors showed that the pump was operating at 2,600 revolutions per minute and helping his heart pump 3.9 liters of blood through his body.
The device simulates a faint heartbeat, but it can’t be detected by placing fingers on his wrist or neck, and Tripp doesn’t have blood pressure that can be measured in the traditional sense.
“It’s like I’m a vampire,” he said, arching his eyebrows with a smirk.
The $100,000 device requires a team of 30 or more medical professionals – including surgeons, cardiologists, nurses, coordinators, psychiatrists, physical therapists and others – to take care of one patient. Primary care physicians typically don’t monitor how the devices are working post-surgery, so the after-care is also done by the hospital.
The six-year cost of LVADs for Medicare patients was $726,000, according to a study published in January 2017 in the Journal of the American College of Cardiology. The costs reflect the intensity of care required for LVAD patients, who must be constantly monitored for potential infections, bleeding and for risk of strokes.
“The benefits outweigh the risks, but the risks are real,” DeNino said.
ONGOING TECHNOLOGICAL PROGRESS
Dr. Lynne Warner Stevenson, a cardiologist at Vanderbilt University Medical Center in Tennessee, said LVAD use has plateaued in recent years, but that further improvements in technology could make them more common.
“One of the big hopes is that in the future, they will be fully implantable,” Stevenson said. That time, if it happens, could be many years in the future, but a fully implantable LVAD would be exponentially smaller. It would eliminate the need to carry around a monitor and would reduce the infection risks from having the tube perpetually inserted into the body.
“There has already been a remarkable technological progress from the original LVADs,” Stevenson said.
David Brown, 65, billing director at Mayo Regional Hospital in Dover-Foxcroft, underwent LVAD surgery on March 5 at Maine Med. Brown said he didn’t have any symptoms, but when fluid was found on his lungs last fall, doctors discovered that his left ventricle was not working properly. An avid golfer, Brown said his goal is to return to the links by July.
“It’s amazing technology, and up until three months ago I had no idea something like this even existed,” said Brown, who expects to be a candidate for a heart transplant. He said he will be able to do most activities.
“My driving distance might be down a little, but I’m hopeful my short game will keep my score down,” Brown said.
Tripp, who needed a quadruple bypass after a heart attack at age 45, said the quality of his life has improved dramatically.
The bypass worked well for a decade or so, but Tripp said he started feeling increasingly lethargic the past few years, a decline that accelerated in 2017. One day at his office in Portland last fall, office manager Lauren Johnson noticed that Tripp’s fingertips and lips were blue. She insisted he go to Maine Med.
The hospital admitted him immediately, and after weeks of tests, doctors determined he was a good candidate for an LVAD. They performed the surgery last November.
“Call me stubborn, but I wasn’t afraid,” said Tripp, who is single. “As I was going into surgery, I looked at the lights over me and I thought, ‘I hope I open my eyes after this.’ ”
LIFE-SAVING AND LIFE-CHANGING
Tripp, owner of Proactive Resources ad agency, said the bag he must carry with him at all times is about 8 pounds, which has caused him some shoulder pain. And every other day he has to change the dressings where the line goes into his abdomen.
“I can’t take a shower. I have to take ‘birdbaths’ all the time,” he said, rolling his eyes.
Tripp is one of the founders of the DownEast Pride Alliance – a pro-LGBT business networking group – and has been active in promoting businesses that are friendly to same-sex couples seeking wedding services.
The surgery and time in the hospital temporarily damaged his taste buds, and it’s taken months for that sense to come back. Sour substances still don’t taste right, but he expects they will by the summer.
Tripp is a “foodie” – favorites are Thai and Italian – and one of the founders of the Portland Supper Club. He also collects old recipes and loves to go antiquing and to flea markets – all activities he recently resumed.
He said he feels better every month, and based on what doctors have told him about where he is on the waiting list, Tripp believes he’ll receive a heart transplant within a year.
He wants to purchase a summer home in Old Orchard Beach and enjoy a new backyard patio at his home in the West End of Portland.
“This has allowed me to have fun again,” said Tripp, pointing to the LVAD bag. “I feel alive.”
Joe Lawlor can be contacted at 791-6376 or at:
jlawlor@pressherald.com
Twitter: joelawlorph
Send questions/comments to the editors.
