Longest surviving ICU patient goes home
July 20, 2007, ST. LOUIS – When Wilson Guthrie entered Barnes-Jewish Hospital, the birds had begun flying south for the winter.
The next time he stepped outside, the Cardinals were trying to stay in the pennant race.
With a stay lasting from October 31, 2006 to July 21, 2007, Guthrie is thought to be the patient with the longest stay in Barnes-Jewish''s cardiothoracic ICU to be discharged.
“I''m very excited for him,” says Nader Moazami, MD, surgical director of the artificial heart program at Barnes-Jewish Hospital and Washington University School of Medicine. “Seeing him go home is wonderful.”
Guthrie, 61, suffers from end stage congestive heart failure. A resident of Shawnee, KS, he was airlifted in October to Barnes-Jewish from Kansas University. “When he arrived he was almost dead in kidney, liver and respiratory failure,” says Dr. Moazami.
Once in St. Louis, Dr. Moazami and his team implanted a VAD (ventrical assist device) in Guthrie because his heart was too weak to pump on its own.
“Because he was so sick, the first VAD we put in was a temporary device called the Abiomed ventricle,” says Dr. Moazami. “It actually sits on the outside of the body with cannulae connecting it to the heart through the skin.” The device then helps the heart pump oxygen-rich blood through the body.
“We were able to place him on this device ''off-pump'' which helped in stabilizing him without getting into excessive bleeding,” says Dr. Moazami.
Guthrie was so sick that it took several months for him just to recover. “He wouldn''t be here without the device,” says Teresa Rico, Guthrie''s sister. “But he was so sick he had numerous complications.”
The device was temporary and not suitable for discharge out of the hospital, so Guthrie had to stay hospitalized until his health improved.
And improve he did. In fact, a Christmas "Miracle" happened according to Rico. It was the day his kidneys began to work again. "That was really the first step in him getting back to health," she says.
Guthrie kept improving while doctors thought about next steps. “For a while we were going to transplant him but then we didn''t think he would be a suitable candidate,” says Dr. Moazami. “As a result we chose the HeartMate II.”
The HeartMate II is a next generation heart assist device designed to provide long-term cardiac support for patients in need of a heart transplant. Surgeons have been using VADs for close to a decade, but the HeartMate II differentiates itself from its larger predecessors.
Those devices make loud clicking sounds as they pump blood though the body and cannot be used in small-sized patients because they take up too much room in the abdomen. The HeartMate II is noiseless, much smaller at about the size of a finger, uses a rotary pumping mechanism to move blood through the body and is thought to be more durable.
“This is a significant advancement in technology in supporting patients with end stage heart failure,” says Dr. Moazami.
Since HeartMate II is still an investigational device, Dr. Moazami and his team had to go through several hurdles with the FDA, insurance and the company to get it approved on a "compassionate use" basis.
The HeartMate II not only helped get Guthrie out of the ICU, it will stay with him when he returns to Shawnee. The device is portable and Guthrie will live with the device pumping his heart for the foreseeable future.
“The nursing staff in the ICU was wonderful,” says Rico. “We joke it must be a requirement to have a good attitude here, and thanks to them and doctors like Moazami - who cares so much - we have a lot to be thankful for.”
While Guthrie has had a family member along side every day of his hospital stay, he looks forward to seeing his two daughters and five grandchildren, who were not able to visit.
Says Rico, “We have high hopes he''ll be able to enjoy life at home.”