Jay Sanchez

Impella® Heart Pump Helps Give New Mexico Guardsman Jay Sanchez Second Chance at Life

Spinning Out of Control

After working all day with the New Mexico National Guard, Chief Warrant Officer Joseph “Jay” Sanchez went to a spinning class before retiring to his Santa Fe home for the evening.

It had been a long day, Thursday, April 14, but Jay felt fine. And why wouldn’t he feel fine? As a mountain biker, road biker and snowboarder, he was in good shape, especially for a guy in his early 50s. He ate well and didn’t smoke. Over his 25-year career in the National Guard, first in electronics and then in supply logistics, he had always met the Guard’s minimum physical fitness requirements and then some.

A certified indoor spinning instructor, Jay was just a student in the spinning class that day. After the class, he drove home. A couple of hours later, he got ready for bed. But something didn’t feel quite right.

It was after 8 p.m. when Jay got dressed again and drove to the Emergency Room (ER) at Christus St. Vincent Regional Medical Center in Santa Fe. He parked the car, walked through the front door of the ER, and presented himself at the front desk.

Before he could say a word, he collapsed to the floor.

The Widow-Maker

As the ER personnel at Christus St. Vincent Regional recall, Jay’s eyes rolled back, he hit his face on the counter, then fell backwards and hit the back of his head on the floor. An ER doctor on the other side of the counter jumped over the counter and immediately started giving Jay cardiopulmonary resuscitation (CPR).​

Jay would receive CPR for more than 50 minutes. His heart would need to be defibrillated – shocked back to life – four times. He was clinging to life.

The ER team finally got him stable enough to take a computed tomography (CT) scan of his head to see if the fall had done damage to his head. The good news: The scan did not show any bleeding in his brain.

The bad news: Jay was in cardiogenic shock, a life-threatening condition in which the heart is suddenly unable to pump enough blood and oxygen to support the body’s vital organs. In cardiogenic shock, the heart muscle begins to lose its ability to contract, causing a vicious spiral of reduced cardiac output, low blood pressure, and weaker contractions. The shock was likely the result of a massive heart attack. In the past, patients in cardiogenic shock usually died; now, if treated immediately, about half survive 1. Risk factors for cardiogenic shock include older age, a history of heart attacks or heart failure, coronary artery disease that affects the heart’s major blood vessels, high blood pressure or diabetes.2

Jay had none of these risk factors.

Jay was rushed to the cardiac catheterization laboratory – or “cath lab.”  There, physicians found two of the three main heart arteries were blocked. A blockage in the left artery has been dubbed “the widow-maker” because few patients survive it.

Mark Zolnick, MD, FACC, FSCAI, an interventional cardiologist at the New Mexico Heart Institute, performed an angioplasty and placed stents to reopen Jay’s arteries.

Would it be enough to save his life?

Tiny Heart Pump

Jay’s blood pressure was weak and his oxygenation kept dropping through the night.

“I met with his family at 7 a.m., and it was a pretty grim picture. I didn’t think he would survive the weekend,” said Timothy Vellinga, MD, FACC, FSCAI, an interventional cardiologist at the New Mexico Heart Institute.

On his present course, there was a strong possibility that Jay could die.

Except that there was one more option – a tiny heart pump called the Impella 2.5®. The Impella 2.5 is the world’s smallest mechanical cardiovascular support system made by Abiomed, Inc. On the market since 2008, in April 2016, the U.S. Food and Drug Administration (FDA) pre-market approval, which is the highest form of approval by the FDA, to the Impella heart pumps to provide treatment of cardiogenic shock.

Consisting of a tiny pump inside a catheter, the Impella 2.5 has an electric motor that can pump about 2.5 liters of blood per minute3. The device is small enough to allow doctors like Dr. Vellinga to insert it through the femoral artery of Jay’s groin to the heart’s main pumping chamber. There it propelled blood from Jay’s left ventricle into his aorta, increasing the pressure and flow for vital organs like the brain, liver and kidneys.

Impella heart pump also unloads (takes work away from) the heart.

By assisting in the function of Sanchez’s heart, the hope was that Impella would allow his heart a chance to rest and heal4.

Twinkle, Twinkle Little Star

Through his military identification, Jay’s superiors at the Guard were notified that he was in the hospital. His commanding officer in the Guard came to the hospital to identify him.

After a glance at the patient who lay there with the multiple tubes sticking out of him and a swollen head, the Guard officer said, “No, that’s not my guy.”

He was asked to look closer.

“Oh, my God, it is him!”

Jay’s family came, too, and they looked for ways to lift his spirits. A single dad, Jay adored his 4-year-old daughter, Emily. But she was too young to visit the Intensive Care Unit (ICU). So his family recorded Emily singing “Twinkle, Twinkle Little Star,” and kept it playing by his bedside as he lay unconscious.“

“He had a strong support group from his military colleagues and his family,” Dr. Vellinga said. “They were there the whole weekend.”

​Meanwhile, the Impella 2.5 was doing its job and allowing Jay’s heart to rest. “He just kept getting better and better,” Dr. Vellinga said.

By Sunday, Dr. Vellinga was confident that Jay was on his way to recovery. After several days, the Impella 2.5 was removed, and Jay’s heart was strong enough to function without mechanical support.

But a massive heart attack can inflict significant damage on both the heart and, potentially, on the brain, given that both were deprived of oxygen.

The Road Back

And after 10 days at the hospital, Jay was released to go home. For the first two weeks at home, members of his family stayed with him to make sure he was alright and had everything he needed.

He was able to drive to cardiac rehab and perform other types of errands, but he got fatigued very quickly. Slowly, week after week, he felt better and better. A month after starting rehab, Jay said he felt 70 percent better.

Most importantly, he was well enough for Emily to stay with him when it was his time to see her.

Three months after leaving the hospital, including months of cardiac rehab and medication for his heart, Jay was healthy enough to return to work at the Guard. “I feel great and I am working out again,” he said.

Jay now feels almost 100% back to the way he felt prior to his heart attack.

Aftermath

Every year for the past 15 years, Jay has participated in the Santa Fe Century, a 100-mile bicycle ride designed for riders who are in good shape and have trained for the event.

The ride, which presents a challenge both in distance and elevation changes, features scenery that ranges from the pinon trees of the high desert to the grassland of the open plains. The ride finishes with a breathtaking descent into the Galisteo Basin.

He missed last year’s ride due to his heart attack, but he participated in the May 21, 2017 event and completed a 75-mile ride.

About five months after his heart attack, Jay attended a Heart Recovery Reunion to celebrate his recovery at Christus St. Vincent Regional Medical Center.

“There’s no way I would have survived without the Impella pump and the support of my physicians,” Jay said. Without the pump, he had been told there was a 99 percent chance he would have died.

Jay got a second chance at life, a second chance to watch his daughter grow up. He tells everyone he has a new birthday – April 15.

“That’s when the Impella heart pump and my doctors helped to give me my life back,” he said.

Impella® Protects the Heart During Cardiogenic Shock

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