The Queen’s Medical Center
The Case:
A 42-year-old female patient went for a routine valve replacement at another hospital. That routine replacement became an urgent situation when her heart began to fail during the operation. She was immediately transferred to Queen’s Heart where we had the technology and the multidisciplinary team to save the patient’s life.
●●●
When the patient arrived at The Queen’s Medical Center—where her brother is an ICU nurse—her chest was open and tubes from her procedure were still in place. We immediately put her on a machine that handles the heart and lung function called an ECMO. The situation was dire. Her heart function was at 10% and the only thing keeping her alive was the ECMO machine. The Queen’s Heart multi-disciplinary team was there and ready to exhaust every possibility to help the patient regain heart function.
The ECMO machine was doing its job, keeping the blood circulating. But that was the only thing keeping the patient alive. We had to make a big decision – do we risk flying her to the mainland to receive a heart transplant? Or do we try everything in our power to help the patient regain heart function when her mortality rate was so high? Our heart specialists contacted heart transplant offices to determine if she would be a candidate for a new heart, but after weighing the risks of the transfer versus the possible but slim chance of a positive outcome, we determined that transferring her to the mainland was not the best option.
For the next 12 hours, our team supported the patient, watching and waiting for possible improvement. Seeing none, the heart failure team, working together with the intensive care and cardiac team, collectively decided to return to the operating room and see visually what the heart was doing. We removed the clamps around the heart and began cleaning out the blood clots and excess blood from the previous surgery. During this process, we were hopeful when we saw one of the heart valves start to open.
The more clots we took out, the more the heart began to function. The team monitored the patient for 45 minutes with the heart and lung machine before turning the ECMO off to see if the patient’s heart could function on its own. We took out the pump, and we were thrilled when the heart started beating on its own. We were relieved that our skilled care and vigilance had prevented the need for what would have been an extremely risky heart transplant.
Soon, the patient was off all machines and was improving by the hour. As her situation improved, she became well enough to be transferred back to her original hospital for observation and reunited with her family, including her brother the ICU nurse at Queen’s.
●●●
Good News Summary:
Our Queen’s Heart multidisciplinary team of specialists joined together to take a patient from 90% heart failure and mortality rate to regaining all heart function and going home in 5 days. This is why we are Hawaiʻi’s lifetime partner in health.
