The day it occurred to Alberto Gutiérrez to step on the security arch of a Tax Agency office, the security guard almost got hit by something.
Gutiérrez, 75, carried two batteries on both sides of his abdomen connected to a remote control kept on a shoulder strap and from it another cable came out from his stomach.
The watchman, he recalls, directly thought that the man who had just crossed the threshold was looking to blow himself up in the building.
He now tells it sarcastically: “Sure, they looked like explosives.
And I thought: “But what if I come to pay”.
What Gutiérrez wore, like another hundred heart failure patients in Spain, was a mechanical heart.
A ventricular assist device that has allowed him not to die for three years, as planned.
"Let's see how I explained what seemed like science fiction," he says.
Gutiérrez met this Thursday with another dozen patients at the Puerta de Hierro hospital in Madrid, where these "gadgets" were implanted, as he calls them.
A mechanism that consists of a turbine connected to the tip of the heart, in the left ventricle, which collects the blood and drives it to the ascending aorta and this allows it to circulate to the rest of the body.
The cardiologist, head of the Advanced Heart Failure and Transplant Unit, Manuel Gómez Bueno, explains that "it does not replace the function of the heart, but allows it not to suffer so much, that the heart rests."
This turbine works by an internal pump connected by a cable that goes through the skin to a controller and external batteries.
The mechanical heart arrives when there is nothing more that can be done.
When there is no other option than to wait for a transplant, which can last a few years, or for patients who are not even on the list, hospital doctors explain.
The second case was that of Gutiérrez, who was informed that due to his age he would not be suitable to receive the organ.
“It was the easiest decision of my life.
Either die or implant the machine ”, he points out.
While he is speaking, he is interrupted by his wife, Mariluz Sánchez, who has been in charge of very precise and very risky care since 2019, such as treating the still open wound in the hole of the cable that goes to the heart: “Yes, but they told us very difficult things .
Remember the strokes”.
The surgery to implant the device is very complicated, the specialists warn, as is the situation in which the candidates for these mechanical hearts find themselves.
Also they
risks of wearing a strange device attached to the heart and connected to the current.
The most serious are strokes or intestinal bleeding, although the most recurrent is the infection of the hole where the cable exits.
"That is why the role of caregivers [the vast majority are women] is key," says the nurse who has treated them at the hospital, Teresa Soria.
The patient Juan Pablo Rodríguez, 33 years old.
JOHN BARBOSA
The 14 patients who attended the Puerta de Hierro hospital in Madrid this Thursday were men, more likely to suffer from this type of pathology, and with them were their wives, who silently carry the fear and anguish of learning to use these devices do expert nurses every night.
“I have experienced it in a very positive way, the truth.
The other face was much darker.
The plan was to die or have a very short period of life”, admits Consuelo Caselles, wife of José Maria Ayerbe Irizar, 66, in her case the options to obtain a transplant had been reduced by half, due to her blood group. (B negative) and for a protein, so he decided to also have the machine placed.
He underwent surgery in May of this year.
In Spain, 365 mechanical hearts have been implanted from 2007 to October 2022, according to the Spanish Registry of Long-Term Ventricular Assists.
Although these days there are only about 130 patients with this device.
“There are patients who have been living for about 10 years who continue to live like the first day.
Statistically, around 60% of patients are alive after five years, although many of them have received transplants”, points out the cardiologist Gómez Bueno.
The number of interventions has multiplied in the last two years.
While at the beginning only one or two patients were operated on, in 2021 39 were implanted and this year they already have 60 assistances.
The Puerta de Hierro Hospital in Madrid and the Bellvitge University Hospital in L'Hospitalet De Llobregat have assisted more than 50 each.
In United States,
A beep sounds in the hospital auditorium.
Gutiérrez and Sánchez become very straight and stop talking.
Gutiérrez takes hold of the shoulder strap where the control is, it has already become a reflex action.
"Even when the refrigerator beeps because the temperature drops, we get scared," says the woman.
Once, the control of the machine stopped working and, although they always carry a spare, Sánchez had to summon the courage to quickly change one for another that he had not even tried.
“They told us that even if it stops, you have your heart.
But put yourself in my shoes at that moment”, says Gutiérrez.
The most problematic thing for the couple has been traveling.
"It seems that we are going with the trunks of Piquer," says Gutiérrez.
In addition to having to request a permit to fly at the airport, they must carry a suitcase with everything they need: charger, batteries, cables, cure kit, in addition to their luggage.
They always look for a hospital close to where they are going to stay.
"The problem is that not all hospitals know how this works," says Sánchez.
Gutiérrez suffers from gallstones and they fear that one day he will have to go to the emergency room and they will not know how to treat him.
“There are many specialists from other hospitals in Spain who have come here to learn how the machine works, although others still find it somewhat curious.
They have come to ask me if they can auscultate me to hear how it is going, ”says Gutiérrez.
DVD 1135. Madrid, 11/24/2022.
Reports of patients who have been fitted with a mechanical heart.
In the photo, José Maria Ayerbe Irizar, 66, and Consuelo Caselles Herrero, 64. (Photo: JUAN BARBOSA)JUAN BARBOSA
Juan Pablo Rodríguez is 33 years old and is one of the youngest patients to have this device placed.
He has had it for three years and in his case it is temporary, while he progresses on the transplant list.
He suffers from congenital dilated cardiomyopathy.
His mother died of this, his grandfather also and his uncles suffer from the consequences of the same disease.
"The heart was very big, it did not fit in the ribcage," he explains.
He says that while he waits for a heart to arrive, he can lead a more or less normal life, although he cannot travel more than two hours from Madrid in case a transplant appears: "Now I can carry my daughters, which was so important to me." .
Rodríguez is three, the eldest, eight years old, and receives a disability pension of about 450 euros a month.
“And you don't live with that, it's my wife who works.
Sánchez addresses the rest of the patients and their wives from the assembly room, as if he were speaking to a family: “We all know in what condition we have come to the hospital, and in what condition we are in now.
And I want to leave you with a sentence that a doctor told me: this operation, this suffering, is not done to survive, it is done to live”.
Dr. Gómez Bueno adds: "What seemed like science fiction is a reality."
The group of patients with a mechanical heart at the Puerta de Hierro Hospital in Madrid. JUAN BARBOSA
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