Andrew Gemmell was born in 1986 with Tetrology of Fallot, he underwent surgery at 8 months old to patch his large VSD and relieve his pulmonary stenosis. Unfortunately due to complications of a stroke and 3rd degree heart block his recovery was complicated. February 3rd 1987 Andrew recieved his 1st pacemaker. He quickly recovered from the stroke however complications related to his pacemaker plagued him for the next 10 years and beyond with the realization in 1997 that his heart suffered from “pacemaker syndrome”. He had significant damage to his left ventricle and was upgraded to an ‘NSynch dual lead pacemaker. I questioned what this would mean long term for Andrew and started to keep track of advances being made in the area of Left Ventricular Assist devices. In 2002 Andrew began having issues with atrial fib and flutter, having to be cardioverted for the 1st time. It was decided that the damage to his left ventricle was taking it’s toll and the ‘NSynch was no longer doing the job coordinating the normal rythym and for the first time his Pediatric cardiologists suggested we may need to think about a heart transplant. First they had one more trick up their sleeves in a new pacemaker that had yet to be used in a case like Andrews it was a Bi Ventricular Pacer with a third lead to the left ventricle….it worked…Andrew felt better than he ever remembered feeling in his 16 years. His Bi Ventricular Pacer helped him soar through his diagnosis in 2008 and treatment in 2010 for testicular cancer. Unfortunately by 2011 even this pacer proved it could no longer sustain his heart. A routine and long overdue heart cath was done in Feb. 2011 during which was discovered that not only was his left ventricle in bad shape but his right ventricle was also beginning to fail. We started looking into options regarding where and when Andrew could be evaluated for a heart transplant…..but there was a problem he had only been in remission from his cancer for just over a year. He now had questionable enlarged lymph nodes in his chest. For his own safety (to lesson the chance of rejection due to his already compromised immune system and lesson the risk of recurrence of the cancer) we were told a transplant should not be done for at least another 4 years… By July Andrew was in end stage heart failure, in the hospital on Milranone. Pediatric Cardiac Surgeon Dr. George Alfieris from Gollisano’s Children’s Hospital in Rochester, NY offered to take Andrew to Rochester where on July 18th 2011 he along with the transplant team in a 14 hour operation implanted Andrew with an Left Ventricular Assist Device, bypassed his pulmonary valve with a conduit with pig valve and removed the questionable lymph nodes which turned out not to be cancer but were sarcoid. In April of 2012 Andrew recieved his 1st pacer/defibrilator combination and remains cancer free for 6 years now. In November 2014 after his last ICD replacement his overused pocket would not heal. This sent him to Cleveland clinic where the 12 week old ICD was taped to his chest while all 4 old leads were removed in a very delicate 4 hour surgery by some of the best surgeons in the world. IV antibiotics were started while the old pocket began to heal and a new ICD was placed in a new pocket in his right chest. 2015 has been fairly uneventful from a heart/LVAD perspective and we like it that way!! Andrew and wife Kara are expecting their first baby in June for now he is forgoing the transplant option.
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