Very Low Heart Functioning

[leslie328]

A close relative has congestive heart failure. Due to treatments for Cancer, etc, he is not a candidate for transplant nor any additional surgeries. He is 60 years old. His heart functioning is now around 12%. Despite being very careful as to what he eats, and following all medication regiments very well, his abdomen fills with fluids regularly and he has to go in have it drained. He can walk about 25-50 yards before he becomes so winded he has to rest.  I have been told that his life expectancy at this point is "very limited", but not sure what that may mean? weeks? months? I know there is not crystal ball, but in general what is the expectancy at this stage of heart failure? thank you.

[ed34]

Hi again,
            wow I find it hard discussing such an ill patient, it kinda hurts. The device you describe is an ISD which shocks the heart if it stops and regulates any problems with rhythm. The device I mentioned is a Left ventricular assist device. A small pump inserted into the heart where it does most of the work, letting the heart rest. They usually install them before the patient gets so critical though. Some people have even shown improvement with these devices, enough to have them removed and be taken off a transplant list. Nobody quite understands how the heart seems to improve in this way.
I really don't know that to suggest and I really am so sorry to hear about your close relative. Have you considered stem cell therapy as a last resort? I'm not sure of your thoughts on that. I don't know if his kidneys are strong enough to handle a PCTI (angioplasty type procedure).
If his major organs are shutting down, it really doesn't sound like your relative has very long.

[leslie328]

thank you for your answers and for your suggestion about transplants, I am so happy for your daughter that this was an option for her!
In this case, he has been well evaluated and transplant is not an option.

[grendslori]

Has he actually been evaluated and turned down by a transplant team? Or is it that his regular doctor is saying he can't have a transplant, that he wouldn't be eligable? Not every transplant center will turn down a patient with the proiblems you describe. Have you considered trying to go to a different facility? My daughter had kidney dysfunction, lung issues, Rhuematoid Arthritis, Steven Johnson Syndrome (which is a drug intolerance issue) and severe heart disease and they did her transplant when she was 22. While my daughter was suffering from a different form of heart disease than your relative, she too could not walk very far without stopping and the summer she recieved her new heart, she told me that she would not have lived to the end of the year. When she went on the list, we were told that patients usually go on the list when it is felt that they have about 12-18 months left to live; that allows them time to find a donor. Hopefully you live that long. There have been people who have had a transplant after a diagnosis of cancer, but there are guidelines where that is concerned.  

[leslie328]

thank you for your response. He has a device installed to help prevent the heart from stopping (not sure which device it is). He cannot have more surgery due to the low functioning of his kidneys and liver and the extent of the heart damage. His heart is deteriorating, this latest measure was a significant drop. The bottom line is that he is not going to get better, I am just trying to understand what the time line is, -- though I realize that may be impossible to determine. not trying to be morbid, just prepared. thank you.

[ed34]

It really is a problem because they say he cannot have surgery. Having treatments for cancer is not a limitation of surgery that I'm aware of. My wife had the full allowed dosage of both chemo and radiotherapy, and has since had very traumatic surgery. I'm surprised they didn't install a VLAD or something to see if he improves, but perhaps he has too much actual heart muscle damage?
"very limited" can mean anything really because nobody has the answer.It all depends on other medical conditions etc. I read a case the other day where a lady was told her husband (15%) had about 1 year. 8 years later he is still eating his healthy diet. He suffered numerous heart attacks in his later life.
Has the 12% been the same for a considerable time? or is it dropping?

[leslie328]

Congenital heart disease. His one valve has been replaced twice. Apparently he also experienced a virus at some point that lead to enlarged heart.

[ed34]

First, what was the cause of the heart failure?