Lighter, improved heart pump

The strap and battery pack worn over Roger-Guy M. Folly’s shoulder gives new meaning to wearing your heart on your sleeve.

The pack is an essential part of the machinery that keeps his heart alive. The battery provides power to a tiny pump implanted surgically inside his body to force blood through key arteries in his weakened heart. It thus enables him to maintain a more or less normal existence — within limits.

The implant is known technically as a left ventricle assist device (LVAD) and commercially as Heartmate II, a lighter, more advanced version of Heartmate I. As outlined in a recent study by Dr. Leslie W. Miller, the Washington Hospital Center’s director of cardiology, and published in the New England Journal of Medicine, the device is intended to give long-term cardiac support to patients with advanced-stage heart failure.

People such as Mr. Folly are medical pioneers, but for him, the experimental aspect is moot. Agreeing to the implant was a matter of life or death.

“I had no choice,” says the retired Voice of America broadcaster, a District resident. “It was either [get the implant] or stay in the hospital and die.”

The operation was done June 12, a week after his 73rd birthday.

“The doctors’ communication with me was very realistic about relative success and failure,” he notes.

Like artificial hearts, LVADs don’t come without the possibility of complications. Weeks of training are necessary, with a patient’s closest relatives or friends involved in the process. There are inconveniences, such as having to carefully clean and dress daily an incision the diameter of a small finger in the side where bandages protect tubing connecting the battery to the pump.

Sleeping on one’s stomach is out of the question. Taking a shower requires wrapping oneself in plastic to cover the bandages.

The battery pack by his side weighs close to 11 pounds and “feels like a small suitcase,” Mr. Folly jokes. A person must be attuned constantly to electronic signals warning of the need to change a battery when power gets low. Mr. Folly has not yet been given permission to drive, but he expects that will happen soon.

For many patients, the device acts as a bridge until a new heart becomes available for them. More than 2,600 people in the United States are awaiting heart transplants, according to the United Network for Organ Sharing.

Because of the scarcity of donor hearts, older patients are not always eligible for a transplant and look to the Heartmate as their lifeline for an indefinite future. According to Dr. Miller, the new-generation pump is expected to last five to 10 years.

Mr. Folly, a native of Togo in West Africa, has had a long and troubled history regarding his heart, extending back to 1968, when doctors at the American Hospital in Paris detected that he had “an enlarged heart — an athlete’s heart.”

He wasn’t really an athlete, he told them. Then it was thought that a virus dormant in the heart tissue had emerged as he had grown older and the tissues had weakened.

He had a pacemaker installed more than 20 years ago when it was established that his heart muscles were losing strength. Matters grew worse slightly less than three years ago when he found himself being out of breath and unable to talk with ease. Medications helped, but not entirely. In March, he was going to the hospital emergency room every 10 days. That brought on the decision to try the Heartmate.

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