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Bob Lancia: VAD and Heart Transplant

Bob Lancia | UPMC Heart and Vascular Institute

The Challenge: Heart Failure

Bob Lancia, 55, a resident of West View, Pa., loves his job completing building maintenance for the University of Pittsburgh. But heart problems starting in 2010 made his very hands-on job more and more challenging.

“It got to the point where it was hard to walk from building to building. I was constantly trying to get to the next street corner, so I could sit down and catch my breath,” Bob says.

Bob’s heart issues started to become evident in 2010 when he had a mild heart attack. He went to UPMC Passavant for treatment and began routine follow-ups with a cardiologist for his heart issues.

He was able to function normally, though. He continued to work and enjoy daily activities until, in 2014, Bob became very sick.

Diagnosed with heart failure, Bob’s ejection fraction — a number that tells how well the heart is pumping blood — was less than 10%. In danger of having sudden cardiac arrest, Bob’s heart doctor prescribed a LifeVest™. The wearable personal defibrillator would shock his heart, should it suddenly stop.

Bob kept taking medicine prescribed to improve his ejection fraction, which rose to 35%. But since he was still at risk, doctors implanted a pacemaker to replace Bob's LifeVest in October 2014. A pacemaker is a device that treats heart rhythm problems, increasing your heart rate when it beats too slow.

For about three years, Bob’s heart issues were under control.

Then, in the fall of 2017, the oldest of Bob’s three sons unexpectedly passed away. This loss took a severe toll on Bob’s health.

In July 2018, after months of stomach pain and nausea, Bob had surgery at UPMC Passavant to remove his gallbladder.

Two weeks later, Bob felt like he had a fever. His doctors urged him to go to the ER.

Upon admission to UPMC Passavant’s ER, doctors found that Bob had an aortic aneurysm and a type B aortic dissection.

  • An aortic aneurysm causes a bulge in the wall of the heart's aorta. This major blood vessel carries blood from your heart to the rest of your body.
  • A type B aortic dissection is a tear in the descending part of the aorta.

Due to his weak heart and other health issues, Bob’s doctors felt it best to send him to UPMC Presbyterian in Pittsburgh. Once there, he met Ravi Ramani, MD, a heart doctor at the UPMC Advanced Heart Failure Center.

The Path to UPMC’s Advanced Heart Failure Center

Bob spent about a month in the hospital regaining strength before his doctors began to assess him for a heart transplant.

The exam revealed upsetting news. Due to the dissection of his aorta, a transplant, or any other type of heart surgery would be very risky.

By the end of August 2018, Dr. Ramani told Bob he wasn't a candidate for a heart transplant.

With his aneurysm making things too dangerous to operate, a disappointed Bob returned home with medicine. Sr. Ramani told him to keep following up with the Advanced Heart Failure team.

Bob was home for about a month. By the end of September, he was back in UPMC Presbyterian.

The Advanced Heart Failure Center team determined Bob’s best option at the time was to have extracorporeal membrane oxygenation (ECMO).

ECMO is a machine that replaces the function of a failing heart. It pumps and oxygenates blood outside the body, which then allows the heart to rest.

Bob’s heart responded well to ECMO — a promising sign that his body was ready to keep on fighting.

The Solution: An LVAD as a Bridge to Heart Transplant

Since his heart responded so well to the ECMO, after a week, Bob had another chance at life. Christopher Sciortino, MD, a heart transplant surgeon at UPMC, installed an LVAD on Bob’s heart.

An LVAD is an internal heart pump doctors give to those in the final stages of heart failure. The LVAD lets people resume a slightly altered version of their daily life.

Drs. Sciortino and Ramani explained to Bob that — despite how his heart was fighting — he was still too high-risk for a heart transplant.

The LVAD did give Bob some freedom, and he was able to go home by the end of October 2018.

Bob’s LVAD worked well, letting him work on regaining strength.

About two months after he had his LVAD installed, Bob started working out again. He walked on the treadmill, gently helping his heart get stronger.

Bob’s body ended up responding well to the LVAD. Bob’s aortic dissection and aneurysm that made a heart transplant too risky had remained stable during his time on the LVAD.

By early December 2018, Bob was on the heart transplant waiting list.

At first, doctors told him he'd be on the list for a while due to factors like age, weight, and blood type. But Bob was only on the list for two months before getting the call that he had a second chance at life. There was a heart ready for him.

“I had just finished my treadmill walk when I got the call. Even though it was sudden, I didn't hesitate. I told my wife, ‘okay, let’s go,’” Bob says.

Bob had a successful heart transplant from Dr. Sciortino in February 2019.

The Results: A Heart That Works Better Than Ever

Today, Bob is still in recovery, but his heart continues to work better than ever.

He hopes to get back to work soon and finish building maintenance in the labs at the University of Pittsburgh.

Bob is very thankful for UPMC.

“I wouldn't be alive if my doctors didn’t fight for me each step of the way,” says Bob.

He is also extremely grateful for his donor and is passionate about organ donation.

Ever since the passing of his oldest son, Bob is very empathetic. The idea of someone else giving their own life so that he could live is an honor.

Bob hopes to meet with his donor’s family via the Center for Organ Recovery and Education (CORE) someday to express his gratitude.

Today, Bob follows up with Dr. Ramani and his team every two months and is starting to feel like his normal self.

“I can’t say enough about the whole team,” says Bob. “The doctors and staff were incredible to not only me but my family and visitors as well.”

Bob is thankful for his journey with UPMC and their commitment to his care.

Bob’s treatment and results may not be representative of similar cases.

LifeVest is a trademark of Zoll.

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