Mark Grigsby

Heart Failure Treatment Leads to a Surprise Ending

Heart specialists at St. Elizabeth Healthcare had been treating Mark Grigsby for months, but his symptoms were worsening. After extensive testing and discussion, they recommended surgery to implant a left ventricular assist device (LVAD). An LVAD is a mechanical heart pump for people like Mark with advanced heart failure. It helps the heart pump blood from the lower left heart chamber to the rest of the body.

“One of the doctors said that if I wanted to live, I needed the LVAD surgery,” says Mark, 55, who lives in Milan, IN. “What I heard was, ‘Do it, or you’re going to die.’”

Each year, only about 2,500 people in the U.S. with advanced heart failure receive a left ventricular assist device (LVAD). The device is designed to decrease heart failure symptoms and improve a person’s energy, stamina and quality of life. Some patients go on to have a heart transplant. Only a tiny fraction of people who use an LVAD end up not needing a transplant or the device anymore. Mark was one of the lucky ones.

A Distressing Diagnosis

Mark’s heart problems began suddenly in April 2022 when he started having trouble breathing. After visiting an urgent care center twice, he went to the emergency department at St. Elizabeth Dearborn Hospital for help. The care team diagnosed him with pneumonia and admitted him to the hospital’s intensive care unit for two days. After he got home, Mark still felt terrible.

Specialized tests at St. Elizabeth Healthcare – Edgewood revealed that Mark had “non-ischemic cardiomyopathy,” a type of heart failure. This term refers to any abnormal heart function not caused by blocked arteries or a heart attack.

“We did not know why Mark’s heart was failing, but we needed to intervene before other vital organs started to fail, too,” says Ashok Penmetsa, MD, a St. Elizabeth Healthcare cardiologist who saw Mark in his Lawrenceburg office after his hospital stay. “I prescribed oral medications, but they were not effective. So I referred him to the Advanced Heart Failure Management Center at St. Elizabeth Englewood Hospital, where I knew the team had the resources and expertise to guide his care.”

“He Could Not Have Been Any Sicker”

Mark’s first appointment at the Advanced Heart Failure Management Center was in September 2022. His left heart chamber, which is responsible for pumping blood out of the heart to the rest of the body, wasn’t working. His heart was still beating, but the left ventricle was floppy and weak and not doing its job.

“The American Heart Association has identified four stages of heart failure, and Mark was in Stage D,” says Casey Behne, RN, the ventricular assist device coordinator at the center. “He could not have been any sicker. We put him on a new drug to help the heart pump more efficiently. But that drug also weakens the heart. He could only remain on it for a few months for safety reasons.”

Mark’s only option was to get the LVAD. The device would improve his quality of life and give the care team time to decide on a long-term treatment plan.

In the weeks leading up to surgery, Mark’s condition worsened. “I couldn’t even walk 20 feet without getting out of breath,” he says. “I was pale, like the Walking Dead. Sometimes, I didn’t think I could even make it through the night. What kept me going was the support of my family, friends and St. Elizabeth.”

Preparing For a Heart Transplant

Mario Castillo-Sang, MD, a nationally recognized cardiovascular surgeon at the Florence Wormald Heart and Vascular Institute at St. Elizabeth, performed the surgery in January 2023. Mark credits him and the entire care team for his relatively quick recovery. “Everyone took time to explain things to me and treated me well,” he says. “I tell people, ‘If you need heart care, go to St. Elizabeth — as long as you go there, you’re in good hands, you don’t have to worry about anything.”

For the next few months, Mark returned to the Advanced Heart Failure Management Center frequently for check-ups and tests to monitor his health. That summer, he started going to Saint Vincent Hospital in Indianapolis for a heart transplant evaluation. Saint Vincent Hospital is an accredited heart transplant center, one of only about 110 in the U.S.

“I was scared — I didn’t know anyone else who had ever had a heart transplant,” Mark says. “I prayed and asked God to help me. What if the new heart didn’t work?”

Thankfully, Mark never had to find out.

Surprise Ending to Heart Failure Treatment

It all began with a series of alarms coming from his LVAD system. “Every time I turned around, my LVAD monitor was going off to warn me there was a problem with low blood flow,” Mark says. “The care team would change the LVAD settings, but the problem kept happening over and over. One time when I was on the phone with Casey, I got 10 low-flow alarms in five minutes.”

Mark’s heart failure specialist, Amaninderapal Ghotra, MD, considered several explanations for the low-flow alarms. “One of the least likely was that Mark’s heart had recovered to the point that he did not need the LVAD anymore,” Dr. Ghotra says. “It’s an extremely rare occurrence — many cardiologists will never see it in their practice.”

Yet, all signs pointed to that very explanation. Dr. Ghotra spoke with colleagues at Saint Vincent Hospital and asked them to evaluate Mark. After additional tests in Indianapolis, all agreed that the LVAD was no longer necessary. A week later, Mark returned to Saint Vincent Hospital for surgery to “decommission” (turn off) the device.

In the end, Mark had the LVAD for just 10 months, long enough to strengthen his heart so that it could pump blood throughout his body without help. As Casey says, “It’s like winning the lottery 10 times over.”

A Full Recovery

Mark is back to enjoying all his favorite activities, including fishing, woodworking, car repair and spending time with his grandchildren. He continues to take medication to keep his heart strong and sees Dr. Penmetsa a few times a year.

“I feel as good now as I felt before all this started,” Mark says. “If I had known back then what I know now, I wouldn’t have worried about anything. The care was great. I never felt like a number. Every single person at St. Elizabeth treated me like family.”