First patient with LVAD to have surgery at VAMHCS

Used increasingly for end-stage heart failure patients, the pump helps his heart’s left ventricle—the organ’s main pumping chamber—pump blood to the rest of his body, prolonging and improving his life. Simply put, without it, Sullins would die. 

“I can never take it off. We have multiple battery packs so that it never runs out of power, and my wife is a certified caregiver for me as she has been taught how to change the batteries,” he said. 

Although he’s lived with this life-saving device since 2021, the important role it plays in keeping him alive proved to be a challenge for clinicians when he needed to have cataract surgery. Because the technology is relatively new, there is little information or experience with patients wearing this device needing invasive surgical procedures, and for this reason, when he approached an array of eye surgeons, there was general reluctance about conducting the procedure. In short, Sullins needed cataract surgery and clinicians in the area were reticent to perform it due to lack of familiarity with the LVAD.

“I started with the VA and then thought I’d want community care, but when people realized that I had the LVAD, no one was interested in doing the surgery, so I ended up back at the VA,” said Sullins. 

Dr. Wuqaas Munir, chief of ophthalmology at the VA Maryland Heath Care System and Sullins’ ophthalmologist, presented the case to the Peri-Operative Services director for the health care system for evaluation.  The Peri-Operative Services director coordinated with a team of cardiologists at the Baltimore VA Medical Center and the University of Maryland, including a cardiology nurse practitioner at the VA medical center who has extensive experience and training in LVAD technology, and the LVAD cardiologist at the University of Maryland. The company that manufactures the device was also contacted, and a company representative agreed to be present during the procedure. With extensive communication between various clinicians at the Baltimore VA Medical Center and the University of Maryland Medical Center, they evaluated the safety of the procedure. The Peri-Operative Services director who reviewed the records and discussed them with the cardiologists, concluded that they could safely perform the surgery at the Baltimore VA Medical Center with the VA nurse practitioner and the LVAD company representative present in the operating room, both knowledgeable about the operation and functioning of the LVAD machine.  

Prior to the day of the procedure, educational materials about the LVAD were distributed to the clinicians. The surgery went so well, that SullinsS is now scheduled for his second cataract surgery. 

“We thought the LVAD heart device would pose a challenge,” said Dr. Munir. “With a lot of coordination, we were able to successfully complete the procedure using a local anesthetic.” 

For Sullins, the surgery alleviated a lot of stress brought about by the increasing restrictions of diminishing vision. “I can see again and use my computer again,” he said, noting that he’s looking forward to the second procedure so that he can resume driving.