Right Team at the Right Time Made Life-or-Death Difference
When Dr. Alexander Truesdell first met Wayne Wallace, he was looking at a man who was facing a “perfect storm” of cardiac complications — a perfect storm that nearly killed the 50-year-old father of two.
Wayne arrived at Inova Fairfax Hospital with rapid ventricular tachycardia, acute decompensated heart failure, and cardiogenic shock. His lungs were filling with fluid and his heart was racing out of control and pumping at only five to 10 percent of its capacity. This put Wayne at risk of massive organ failure. An urgent angiogram revealed that all three of his coronary arteries were completely blocked. Within minutes, Wayne suffered complete cardiovascular collapse and faced imminent death.
But thanks to an innovative set of protocols initiated in 2017 by members of the Virginia Heart team and their colleagues from the Inova Heart and Vascular Institute, a Cardiogenic Shock Team comprised of an interventional cardiologist (Dr. Truesdell), a cardiac surgeon, an advanced-heart-failure physician, and a critical care physician undertook a multidisciplinary consultation that would prove to be critical to Wayne’s survival.
First, it was determined that Wayne would require immediate external mechanical circulatory support to save his life and keep his brain, liver, kidneys, and other vital organs intact. Second, his failing heart would also require ventricular support to recover. In the cardiac catheterization lab, external cardiopulmonary bypass (known as ECMO) was initiated in conjunction with a miniaturized ventricular-assist device (a heart pump known as Impella®) that was inserted through an artery in Wayne’s leg. This kept blood flowing to Wayne’s brain and other vital organs — performing a task his own heart could not. Once Wayne was sufficiently stabilized, Dr. Truesdell performed a complex coronary angioplasty and stenting procedure to open the chronic total occlusion of Wayne’s coronary arteries and restore his heart’s native blood flow.
After 30 days, the man who arrived on death’s door walked out of the hospital’s doors with his family. He is grateful to the entire staff of Inova Fairfax and especially to Dr. Truesdell for saving his life. “Dr. Truesdell has an amazing bedside manner,” Wayne says. “He did a very good job of explaining everything to me and has been a very good advocate for me since I was discharged.”
Dr. Truesdell believes Wayne’s remarkable recovery is primarily due to the efforts of the multidisciplinary Cardiogenic Shock Team and the excellent teamwork of nurses, therapists, and other caregivers at Inova Fairfax. “Having an entire team of critical specialists immediately available to offer their different professional perspectives made it possible for us to evaluate all the options and arrive at the best therapy in an instant. It demonstrates the importance of teamwork and collaboration — and of having the right people in the right place at the right time,” he said.