- The Washington Times - Friday, August 2, 2002

As heart attack victims go, Robert Bothe couldn't have had better luck. When he experienced shortness of breath on Dec. 7, the 57-year-old Glen Burnie, Md., man decided to drive himself to North Arundel Hospital's emergency room which was only about a mile from his home. And when he was transferred to a medical center in Baltimore, a heart specialist visiting from out of town agreed to treat Mr. Bothe.

Besides the good fortune of location and timing, Mr. Bothe can thank technology: State-of-the-art heart pumps were used for the first time at the University of Maryland Medical Center to save his life.

Mr. Bothe, a self-described "type A personality" and two-time heart attack survivor, said his perspective on life has changed dramatically and he treasures his family like never before.

"I've come a long way. I'm lucky to be here today," said Mr. Bothe, who was a National Security Agency analyst for 37 years.

Not a religious man before the heart attack in December, he now attends church every week.

Mr. Bothe, whose first heart attack occurred in 1997, began feeling ill late last fall but didn't know what was wrong with him. He thought he had the flu and was diagnosed with bronchitis.

On Dec. 7, he tried to go to work but was so sick he had to return home. When he experienced shortness of breath, he finally realized he was having a second heart attack.

Mr. Bothe managed to get himself to North Arundel Hospital, where he collapsed. Doctors diagnosed him with cardiogenic heart shock.

Two temporary heart pumps, which helped the left and right ventricles pump blood, were placed in Mr. Bothe's chest that evening just to keep him alive.

His chances of living through the afternoon of Dec. 7 were 20 percent, Mr. Bothe said.

The next day Mr. Bothe was transferred to the University of Maryland Medical Center in Baltimore.

"He had had a devastating heart attack," said Dr. Bartley P. Griffith. "He was so sick that his kidneys weren't working well, his liver wasn't working well; he was only semiconscious. His legs were as big as tree trunks, swollen with fluid.

"His heart was quivering. It wasn't creating much blood movement at all. So we had to move pretty quickly, within hours of him being admitted," Dr. Griffith said.

He later determined that Mr. Bothe had been experiencing a heart attack for nearly a week.

Dr. Griffith was only visiting the medical center to prepare for his transition from the University of Pittsburgh Medical Center.

There, he had served for 20 years as Henry T. Bahnson professor of surgery and chief of cardiothoracic surgery, and implanted one of the first heart pumps in 1985.

Although his staff was not even in place, Dr. Griffith agreed to help Mr. Bothe.

"He said, 'If this is what I'm here to do, let's start with this patient,'" Mr. Bothe said.

Dr. Griffith implanted ventricular assist devices (VADs), otherwise known as heart pumps, in Mr. Bothe.

He would receive two more permanent Thoratec blood pumps the "Chevy truck of blood pumps," Dr. Griffith said which remained in his body for nine weeks. They allowed his heart to regain strength, and the rest of his body to recover from the effects of a near-dead vital organ.

The Thoratec pumps were outside Mr. Bothe's body and were connected to the heart's two ventricles by tubes through the skin. The VADs were connected to an external power source, also through tubes.

The left ventricle is the "power chamber, which pushes the blood into our arteries," Dr. Griffith explained. "You need both [ventricles], but the one that causes the most difficulty is the left when that chamber goes down, you have heart failure or shock.

"The key to this therapy is to keep everything going," he said. "Except for the soul residing in the heart, the only other thing it really does is pump blood."

Mr. Bothe said he was notified that a matching heart might be available at midnight Feb. 19. The heart was a match, and he went into surgery that morning about 6 a.m.

On March 4 Mr. Bothe went home, the heart of a 27-year-old beating in his chest.

Mr. Bothe's pumps were never intended to be anything more than a bridge to sustain him until a heart was available for transplant.

But the future of heart pumps is more advanced and could be a huge asset to the medical profession, said Dr. Griffith, who is the principal researcher on studies of new pumps sponsored by the National Institutes of Health.

Instead of simply keeping patients alive while they wait for a transplant, heart pumps could be used in the future as an alternative to transplant if they are implanted early enough, Dr. Griffith said.

Such a scenario would help solve a huge medical problem: Nationally, 4,200 people need new hearts every year, yet only 2,000 human hearts are available for transplant, said Joel Newman of the United Network for Organ Sharing (UNOS).

Two persons die each day in the United States waiting for transplants, according to Anne Paschke of UNOS.

"If we could have on the operating room shelf something as good as a transplant for most patients, we will have certainly solved a major health care problem," Dr. Griffith said.

One possible model for a permanent heart pump would be attached to the left ventricle and powered by a battery attached to the skin.

"This is where we need to get to," Dr. Griffith said, "so that we don't have to wait for just one of 2,000 human hearts to become available."

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