Managing Heart Care from Home

The device Dr. Sauer was referring to is the CardioMEMS™ HF System – an implantable wireless sensor no bigger than a dime that monitors pulmonary artery pressure and heart rate in heart failure patients. The device instantly transmits reports to the patient's care team, allowing them to adjust medications as needed and monitor heart function remotely.

"It's like a pressure gauge," Dr. Sauer explains. "You can essentially forecast when someone's about to have symptoms of heart failure by watching the trends. Generally, if you're checking it twice a week, you can prevent hospitalizations of heart failure."

The CardioMEMS heart failure device was approved by the Food and Drug Administration in May 2014, and The University of Kansas Health System was among the first in the region to adopt the new technology. Now, the health system has the longest track record of using CardioMEMS in the Kansas City metro area. A dedicated team that includes nurse practitioners, physician assistants and heart failure nurses monitors the readings on a regular basis.

"We started using the device almost immediately after it was approved," Dr. Sauer says. "We've now done 15 or more of these cases, and we've been able to see the technology is very safe."

Charlie received the CardioMEMS device in January 2016. The procedure was minimally invasive and allowed him to go home the same day. Since the device was implanted, Charlie has not been hospitalized.

"This really is a game changer for him," Dr. Sauer says. "He was in the hospital 3-4 times a year for the last 2 years. It's been 6 months since the device was implanted, and that's the longest he's been able to stay out of the hospital."

Finding the right heart care had not been easy for Charlie. At one point, while being evaluated with an electrocardiogram, Charlie's heart stopped twice. He was revived and awoke to surprising news: He'd had a pacemaker placed in his chest and was being transferred to a hospital in St. Louis to receive a mechanical heart pump called a left ventricular assist device (LVAD). Once he arrived in St. Louis, Charlie was prepped for surgery. However, as he was being admitted, he was shocked to learn that his insurance wouldn't cover the procedure.

It was then that Charlie was referred to Dr. Sauer, who was working at Northwestern Memorial Hospital in Chicago. Dr. Sauer performed a minimally invasive aortic valve procedure to correct Charlie's severe aortic stenosis. He also received another lead in his pacemaker to synchronize his heart rhythm. The procedures were successful and, combined with medication, helped resolve Charlie's heart failure symptoms.

"We were able to get him out of heart failure without LVAD surgery," Dr. Sauer says. "As much as we like LVAD technology, it does come with some risk of complications and limitations in lifestyle that you don't want to impose on someone if you don't need to."

When Dr. Sauer made the decision to join the advanced heart failure team at The University of Kansas Health System, he reached out to all his patients, including Charlie, to let them know he would be relocating his practice. A few months after making the move to Kansas City, Dr. Sauer was surprised to see Charlie's name on his schedule.

Charlie continues to enjoy a better quality of life since receiving the CardioMEMS. He is now retired, and spends time with his wife on their farm. Both receive heart care from The University of Kansas Health System and synchronize their appointments to minimize travel time. Although the 6-hour trip is long, Charlie says he appreciates the personal attention he receives at The University of Kansas Health System.

"They're always waiting for me as soon as I get here," he says. "They know me when they see me."

It's possible that heart failure patients like Charlie may need a mechanical heart pump or even heart transplant in the future. But for now, Dr. Sauer sees no need for additional measures.

"His condition is complex," Dr. Sauer says. "But every time we evaluate him, we find something to make him better. He's open to LVAD surgery, but he's obviously hoping he doesn't need it. I'm glad we've given him some years without it."

If Charlie does require future treatments, there's no question where he will turn for help.

"I wouldn't go anywhere else," Charlie says. "Dr. Sauer saved my life. I love him for it too. He's really good."