Patient story: Journey to the edge and back

Mike Holland with part of the medical team that saved his life: cardiologists Ethan Korngold, M.D. (center), and Jacob Abraham, M.D.

On Nov. 7, 2010, Mike Holland, a steel fabricator in Donald, Ore., called his friend Todd Deaton. The two had known each other for years, which is perhaps inevitable in a town of 600 people. Holland was suffering from what he was told was pneumonia brought on by a bad flu, and he was hoping that Deaton, a firefighter, EMT and the town’s mayor, would bring over some oxygen to help him breathe.

Deaton declined the oxygen request, but decided to pay his friend a visit. One look and he could see that Holland’s symptoms weren’t good. He needed to get to a hospital fast.

About a month earlier, Providence St. Vincent and Providence Portland medical centers had each gotten a prized piece of equipment – an external pump that temporarily does the work of a beating heart. For very sick patients the device buys time, allowing their failing heart to recover until they’re well enough for a longer-term treatment.

Mechanical heart pumps aren’t new. For years, cardiologists and surgeons have implanted balloon pumps to give hearts some rest during critical times. The balloons inflate and deflate according to the heart’s rhythms, but they don’t replace its function entirely and they’re less effective when the heart is beating erratically.

Providence’s new device, called a TandemHeart, can circulate as much blood as a natural beating heart, and it works in patients with little or no heart function, including patients with irregular heart rhythms. It can be implanted through open surgery or through a catheter inserted into a leg vein and artery.

The technology is such an improvement over other systems that a team from Providence Center for Advanced Heart Disease, including Ethan Korngold, M.D., and Jacob Abraham, M.D., sought to bring the device to Portland. Donors to Providence St. Vincent Medical Foundation helped to support the center’s services.

The timing couldn’t have been more fortunate. Tests revealed that Holland didn’t have pneumonia, but rather fluid in his lungs caused by a rapidly failing heart. His condition was going from bad to critical.

“The medications needed to support his blood pressure were gradually increasing, which is always a bad sign,” Dr. Abraham recalls. “He was deteriorating before our eyes.”

Holland was sedated and unaware that Providence St. Vincent Medical Center had mobilized a small army to treat his now life-threatening condition – three cardiologists, a heart surgeon on standby, nurses, technologists, a cardiac perfusionist and a TandemHeart rep, who was there for tech support.

Holland’s kidneys began to fail, he needed a ventilator to breathe and his liver was in shock. His family gathered at the hospital. Dr. Abraham explained to them the minimally invasive procedure, drawing a diagram on a piece of paper.

In the catheter lab, Dr. Korngold worked quickly to implant the tubes that would carry Holland’s blood to the pump, which was strapped to his leg. Once the tubes were in place, the pump began to circulate oxygenated blood outside of Holland’s body. His frantically beating heart quieted, its aortic valve shut and his pulse stopped. The machine, whirring at 7500 rpm, had taken over.

Relief and recovery

Even with oxygen-rich blood flow restored, Holland still faced the possibility that his organs would continue to shut down. Only half of patients hospitalized with his condition survive. But after five days on the heart pump and dialysis for his damaged kidneys, Holland began to recover. Doctors removed the device and the tubes, and a few days later, Holland woke up.

“I had really weird dreams,” recalls 52-year-old Holland, describing each in cinematic detail. He’d been in Bend and Alaska. He had a nightmare that he’d drowned in the Columbia River. “Todd was the one who found me.”

Todd Deaton shudders to think what would have happened if he’d brought his friend the oxygen on that Sunday. It would have given Holland some temporary relief for his breathing, but it also might have delayed treatment for his rapidly failing heart.

“He may not have made it through the night,” Deaton says.

Drs. Abraham and Korngold have no doubt. Without immediate intervention, “he would have died probably within an hour,” Dr. Korngold says. “He is exactly why Providence worked so hard to bring the TandemHeart to Portland.”

Seven months after his medical emergency (the cause of his heart failure is still unknown), Holland is back at work in Donald. His kidneys are working fine, and tests show that his heart function is completely normal. He can’t recall anything beyond the ride to the hospital, so he’s learned the details of his illness and three-week hospital stay from his doctors, friends and family.

He did, however, leave the hospital with a souvenir: the picture that Dr. Abraham drew the night of his procedure. The paper has been folded and creased, but it’s still intact.

“I’m probably not even normal yet,” Holland says of his remarkable recovery. “But I’m getting better all the time.”