A New Road to Travel

Robert Mattila, 74, is not one to sit still. The Dousman resident is an accomplished hiker who has completed hikes in Wisconsin, South Dakota and the Rocky Mountains in Colorado. He has also logged more than 750 miles on the Appalachian Trail. But in February 2024, he started feeling unwell.

“I felt lousy,” he said. “I couldn’t sleep and didn’t have an appetite.”

He saw his primary care doctor, who suspected a heart problem and sent Robert to the emergency department at a nearby community hospital.

Cardiogenic Shock May Lead to Heart Failure

Doctors evaluated Robert’s heart function and found he was in heart failure. His heart was not pumping enough blood for his body’s needs, and he was experiencing a life-threatening condition known as cardiogenic shock. The doctor explained that Robert needed to be seen at a hospital with expertise in cardiogenic shock and advanced heart failure. Robert chose Froedtert Hospital, the academic medical center of the Froedtert & the Medical College of Wisconsin health network.

“Within two hours of checking in with my doctor, I was on a helicopter heading to Froedtert Hospital,” Robert said.

A Team of Advanced Heart Failure Experts

When he arrived at Froedtert Hospital, he was greeted by a team of heart specialists, including Rajakrishnan Vijayakrishnan, MD, advanced heart failure and transplant cardiologist and MCW faculty member. Robert was admitted to the Cardiovascular Intensive Care Unit and began receiving an infusion of milrinone, a drug to increase his heart’s pumping ability. Within hours, he started to feel better, but his heart was still not functioning well.

“His heart was very enlarged,” Dr. Vijayakrishnan said.

“The usual size is 54 millimeters, but his was almost 84.”

To determine the next steps, Robert’s case was discussed by a multidisciplinary team of heart failure experts who meet regularly to consider the best treatment for each patient. Because Robert was in his 70s and was treated for lymphoma 19 years earlier, he was not considered a candidate for a heart transplant. The team decided he would benefit from a left ventricular assist device (LVAD), a mechanical pump that would help his heart pump blood to the rest of the body.

In some cases of advanced heart failure, the LVAD is an interim or “bridge” step, helping the patient’s heart to function until a donor heart becomes available. In cases of temporary heart failure, the LVAD allows the heart to heal, and the device is later removed. Dr. Vijayakrishnan said that in Robert’s case, the LVAD would be a “destination” therapy, and Robert would use the LVAD for life.

Life With a Left Ventricular Assist Device

With that plan in mind, Robert returned home with his wife, Nancy, and continued to receive milrinone to support his heart’s contractions. They also began the process of learning from the care team what life with an LVAD would look like.

In June, Robert returned to Froedtert Hospital for surgery, led by Lucian “Buck” Durham, MD, PhD, cardiothoracic surgeon and MCW faculty member, to implant the LVAD in his chest cavity. The device includes a pump that moves blood from the left ventricle of the heart to the aorta and out to the rest of the body. The pump is attached to a cable in the abdomen, which typically exits the body on the right side of the belly. Robert would connect this cable to a small battery-powered computer he would keep in a wearable bag.

In the days after surgery, Robert quickly began to feel better, and Dr. Durham was impressed by his determination to recover.

“He was motivated and knew what his contribution needed to be,” Dr. Durham said.

Froedtert Hospital has dedicated staff who teach patients how to live with the LVAD, supporting them after they are discharged. Robert and Nancy completed the in-hospital training, and Robert was well enough to return home just 11 days after his surgery.

Back to Health — and the Hiking Trail

As the weeks passed, Robert’s heart began to heal, returning to a smaller, healthier size, and he regained his energy. With Nancy’s help, he developed new routines with the LVAD, always carrying back-up batteries and plugging in the device at night while he slept.

When he returned to Froedtert Hospital two months later for a follow-up appointment with Dr. Vijayakrishnan, Robert was pleased to share some news: He and a friend had just completed a 9-mile hike in the Kettle Moraine State Forest.

Looking back over the entire experience, Robert says Froedtert Hospital was the right choice for him.

“I’m glad I made the decision to go there,” he said.

The Froedtert & MCW Comprehensive Heart Failure and Transplant Program has a full array of advanced treatment options. Learn more at froedtert.com/heart-failure.

Froedtert Hospital is one of only three hospitals in the state to be awarded the Gold Seal of Approval by The Joint Commission for its Adult VAD Destination Therapy Program.