A heart to heart transplant story

Shayla was a happy 30-year-old wife and proud mother of a seven-month-old baby when life took an unexpected turn. While she and her husband were settling into the joys of being new parents, they would soon face a challenge they could not have imagined. Shayla was diagnosed with non-ischemic dilated cardiomyopathy, a heart condition affecting her left ventricle, the heart's main pumping chamber.

"My heart was severely enlarged, weak, and was not pumping blood efficiently," Shayla explains. She would ultimately need a heart transplant and began her journey of this lifesaving process at the Advanced Heart Failure Unit (AHFU) and the Sentara Heart Hospital’s Cardiac Surgery Intensive Care Unit (CSICU).

Shayla’s journey begins

Shayla’s cardiac surgery team included cardiothoracic surgeons and anesthesiologists, nurse practitioners, nurses, a transplant coordinator and a social worker who guided her and her family through the months-long process. First, Shayla received an Impella device, a catheter-based mechanical heart pump that temporarily supports the heart's pumping function. The device would provide blood flow to her vital organs by supporting her weakened heart. Shayla’s condition was cardiogenic shock, and the Impella device takes the workload off the heart to support it. The Impella would be the first step in preparing Shayla for a heart transplant, which she would receive after 52 days on the temporary mechanical support.

"With Shayla, we utilized temporary mechanical support as a bridge to transplant," says Dr. Eric Unger, Sentara cardiothoracic surgeon. "With strong family support and Shayla’s remarkable personal fortitude, we focused on optimizing her transplant candidacy during the long and uncertain inpatient wait for a suitable donor."

To prepare Shayla for a heart transplant, her cardiovascular surgeon took the time to get to know her as a person, not just a patient. "Dr. Christopher Sciortino was very personable," she says. "He always found a way to make me laugh. He also was present during my delivery of my son, so I felt it was a full circle moment when he did my transplant."

Heart transplant patients like Shayla can experience a range of emotions as they wait for a heart, then prepare for surgery and recovery. "I experienced sadness and hopelessness knowing that I was, in a sense, dying and could not fix it. I felt like I had lost control of the situation," she says. Coping with emotions of loneliness, fear and even anger, Shayla knew the transplant would change her life. "I eventually became grateful for my situation because I knew I would be walking out of the hospital with a second chance at life and more time with my loved ones. I was grateful that the medical team had intervened and saved my life, and ultimately, I was grateful for the gift of a new heart."
Shayla also realized that her second chance would mean heartbreak for her donor’s family. "I was sad for the donor's family, as I knew what receiving a heart meant for me and for the donor's family."

Complex cardiac procedures like heart transplants involve a coordinated team of healthcare professionals all working together with the patient and their family. Shayla’s case was no different. Every member of Shayla’s cardiac care services team made sure she understood each aspect of the transplant process – before, during and after surgery. Dr. Gilles Dongmo was Shayla’s cardiothoracic anesthesiologist. "Shayla underwent, one of, if not the most, medically complex procedures in a heart transplant. Thanks to the team’s cohesion and experience, Shayla's procedure went according to plan with no major challenges," he says.

Shayla recalled one member of her care team, perfusionist Coresa Klein, who specialized in an area she had never heard of. Perfusionists are highly-specialized members of the surgical team who work alongside doctors and surgeons to operate the heart-lung machine during open-heart surgery, or in Shayla’s case, a heart transplant. "Coresa made an impact on me by educating me on the career of a perfusionist. It is something I wouldn’t have known about otherwise." She learned that their primary role is to take over the function of the patient's heart and lungs, pumping and oxygenating the blood so surgeons can operate on a still heart.

Nurses - at the heart of healing

In addition to her perfusionist, Shayla can name over 25 members of her care team, including nine doctors, several nurse practitioners and over a dozen nurses. Each left a lasting impression on her for the level of care they provided and compassion they showed.

"The nurse practitioners checked on me every single shift they worked, and they took time to get to know, visit, and speak to me, even after I left the CSICU," she remembers. Shayla can name members of her care team like old friends. She credits the CSICU nurses with being there in some of her lowest moments. During her stay in the AHFU, she recalls yet another team of nurses who also helped her cope with her wait. Each one played a part in her heart journey that she will never forget.

"The staff provided hope and optimism by showing up with the best attitude every day," Shayla shares. "They also took time to get to know me and answered every single question I had, especially the nurses. They listened to every fear and concern I had and made sure those were communicated to my care team."

Everyone who interacts with a patient plays a part in their recovery and healing in their own way, including non-clinical staff. "The environmental service staff, specifically Ms. Lavinia on CSICU and Ms. Cara on AHFU took time to ask about me and my son every time they cleaned my room," Shayla says.

Facing such a complex surgery, Shayla was grateful for the time and attention each member of her interventional cardiology team offered. From the anesthesiologists who "listened to all of my concerns and made sure they were addressed prior to surgery" to her transplant coordinator Kristina Louka. If there was one thing that remained constant throughout Shayla’s experience, it was the way her care team educated her along the way.

"What stood out about them was that they were always very transparent and honest with me about where I stood during the transplant process, especially when it came down to selecting a heart," she says.

Dr. Dongmo remembers how this helped Shayla and her family. "During our pre-procedural meeting, Shayla was very calm and seemed ready to proceed with the surgery," he says. "The team made sure to communicate actively, keeping Shayla and her family informed was paramount."

The head and heart connection

Shayla’s mental health experienced some challenges that can go along with facing chronic illness and surgery. On a particularly hard day, Shayla recalls having a meltdown. "Nurses sat with me until I calmed down and helped me regulate and talk through what I was feeling." Shayla was often reminded that ultimately, she had to get back to her seven-month-old son. "My advice to patients and families is to remain as active as possible until their procedure," says Dr. Dongmo. "Having hobbies and interests is a great way to do that. Also, learn as much possible about the procedure, the recovery and ask questions to help alleviate some of the anxiety that comes with chronic illness."

Having a care team that connected her mental health and physical health helped to ensure a positive outcome for Shayla. "Our team focused on easing the emotional stress of her separation from her infant and the gravity of her circumstances as she awaited her transplant," says Dr. Unger. "Through constant reassessment and multidisciplinary coordinated care, she remained fully prepared for surgery. Her outcome and recovery reflect that commitment."

One of the best pieces of advice Shayla received was from her social worker. "She told me that my son would only remember the healthy Shayla and not a sick Shayla, who was in and out of the hospital and could not keep up with him. Remembering that really helped me get through tough days during my stay."

Since Shayla lived in Elizabeth City, North Carolina, her family and friends made the extra effort to visit and stay connected while she was in the hospital. "My husband and son would come to see me," she recalls. "I had family and friends in the area who would come and visit weekly." Shayla’s closest friends would FaceTime several times a week if they could not come to Norfolk to see her. "I had friends from my running club that made sure that my husband and son were doing okay and had everything they needed back home."

A heart full of hope

Shayla’s entire experience, from her heart failure diagnosis to a successful heart transplant, was often marked by periods of uncertainty and fear, but ultimately hope. "I leaned on God with lots of prayer and talks with Him, my family, my closest friends, the medical team, specifically Brandy, the social worker, and the nurses on the floor," Shayla says. She is eternally grateful for her care team who took care of her physical and mental health, uplifting her when times were tough. "Thank you for showing me that there is life worth living," she said.

She offers this advice for anyone facing the same challenge she faced: "There is a light at the end of the tunnel. The life that you will have once you receive your gift and go home beats the life you are living now. Show up each day and fight for yourself and those who care about you. Ask all the questions and advocate for yourself."