First Total Artificial Heart Patient Credits Teamwork
James Carelli, third from left, with his primary nurses from the intensive care and step-down units: Lisa Comis, RN, Frank Melanson, BS, RN, and Heather Bedlion, BSN, RN.
When BWH patient Jim Carelli Jr. spoke to the local media about his experience as New England's first Total Artificial Heart patient, he praised everyone involved in his care, emphasizing BWH's team approach.
For the nurses who contributed directly or indirectly to his care, teamwork and communication with each other and among the multidisciplinary team was essential.
"It wasn't just the primary nurse, it was also all the nurses who were willing to jump in and cover or help any way they could along Mr. Carelli's journey," said Heather Bedlion, BSN, RN, one of the many nurses who has cared for Carelli.
After being diagnosed with cardiac senile amyloidosis almost 18 months ago, Carelli's active lifestyle came to a halt.
The disorder caused deposits of abnormal protein in Carelli's heart tissue, making it difficult for his heart to work. Carelli needed a transplant to save his life, but a donor wasn't available. His BWH care team realized the only option for survival was to remove the 66-year-old's heart and replace it with a Total Artificial Heart as a bridge to transplant, making BWH the first hospital in New England to perform such a procedure.
Heart failure affects nearly 6 million people in the U.S., and while about 100,000 of those patients might benefit from a heart transplant, donor hearts are available for only about 2,000 people per year.
"If I didn't have this device, I probably would have ended up dying," said Carelli, a Holbrook resident who taught science in the Braintree public school system for 32 years and also coached the girls' high school track and field team.
Preparation and training to care for Carelli post-surgery began almost 18 months ago, and kicked into high gear this past February before the procedure. Staff from SynCardia, the maker of the artificial heart, came to BWH to provide initial training for several days, after which nurse educators and nurse practitioners trained staff nurses on the device.
"More than 100 nurses took part in those training sessions," said Maria Bentain-Melanson, MSN, RN, CCRN, CSC, nurse educator for the Cardiac Surgery ICU.
Part of the training was becoming acquainted with "Big Blue," the 418-pound driver that powers the artificial heart. The artificial heart works just like a human heart by pumping blood through the body, and the driver regulates the artificial heart rate and blood flow.
It didn't take long for the nurses to get acquainted with this technology, according to Jackie Gagnon, MSN, RN, CCRN, CYT, nurse educator for Shapiro 7.
"The concept is similar to the way left ventricular assist devices work," said Gagnon. "The hurdle was just having nurses be able to touch and feel this device."
Teamwork between nurses in the intensive care unit and the step-down unit was critical.
"While Mr. Carelli was in the ICU, step-down nurses would come to work alongside the ICU nurses and get a feel for what to expect," said Gagnon.
Constant communication also ensured that Carelli's care was seamless.
"Almost every day, we would email staff with updates on his care, especially when it was a scenario that hadn't been encountered before," said Bentain-Melanson.
Receiving a Total Artificial Heart is just the beginning of Carelli's road to recovery. Now, he waits for a donor who will provide a heart and kidney.
Familiar faces: BWH nurses Katie Carroll, RN, and Kayla Quinn, RN, are Jim Carelli’s former students and athletes at Braintree High School. Photo provided by the Boston Herald.