In an exam room of the Peter Munk Cardiac Centre, Dr. Vivek Rao asks patient Lina Amaral how she has been feeling.
“Are you able to do whatever you want to do from an activity standpoint?” asked Rao, the chief of cardiovascular surgery at Toronto General Hospital.
“I can,” replied Amaral animatedly, adding, “You know that I’ve come close to death more than one time.”
Amaral returns to see her doctor every month. But when she spotted Dr. Rao walking toward her while speaking with Global News, she rushed to him and shouted out, “My hero!”
Her journey has been a long, difficult one, but Amaral said she is doing well and is realizing dreams she never imagined would be possible for someone in heart failure.
“I never thought I would make it to see them (her two new granddaughters),” she explained.
Born just a month apart to two of her four daughters, the babies are a new generation in the Amaral family that Lina said she dreamed she would live to meet.
“My blessings have outweighed my problems,” said Amaral.
She was first diagnosed with congestive heart failure at age 44.
“They’re not sure (but) they think it was a virus that went into my heart instead of going into my lungs,” said Amaral.
She recalled falling very ill a number of years later in 2009.
“I couldn’t breathe, so they told me it developed into cardiomyopathy,” said Amaral.
Cardiomyopathy is a disease of the heart muscle that made it harder for Amaral’s heart to pump blood to the rest of her body.
Amaral is among approximately a million Canadians currently living with heart failure, who have a mean survival rate of just over two years.
“She was very, very sick — clearly she wasn’t going to survive long enough to get a donor heart,” explained Rao.
“There were some challenges trying to find her a suitable heart because she had a lot of antibodies in her blood that made it difficult to find a match.”
The cardiology team implanted a mechanical heart – medically known as a left ventricular assist device (LVAD) –– which has allowed her to beat the odds stacked against her. A ventricular assist device (VAD) is a mechanical pump that is used to increase the amount of blood that flows through the body.
Over the summer, Amaral marked her ninth year living with this pump — which is a record length of time in Canada.
“Most people live two, three years, and here I am nine years later,” she said.
“Over nine years and still hanging in there.”
“Since 2017, the provincial government has funded us to do this type of procedure on patients who are upfront not transplant candidates … we now have the technology that can treat their heart failure and give them some valuable years of life,” explained Rao.
“Five years ago if you were not a transplant candidate … palliation or end-of-life care was your only option. Now if you’re willing to undergo a surgical procedure with the hope that you’ll get several years of good quality of life, we have that available to you.”
For Amaral, she said having the small pump implanted in her failing heart has given her a new lease on life, including quality years with her growing family.
Meanwhile, Rao said he is confident there will be more positive changes coming for cardiac patients.
“I do foresee a day where we’ll sit in front of a patient saying here are your options, we can put you on the waiting list for a transplant and hopefully you’ll get a heart within the year or next week whenever your schedule allows we will implant a pump and that will give you the equivalent life span,” he said.