Complex Course of Treatment Showcases Inova Heart Team’s Approach

With treatment and services from cardiogenic shock to cardiac surgery, advanced heart failure, interventional cardiology, advanced cardiac imaging, nursing and case management services, IHVI has built a comprehensive care team to support critically ill patients from the time they come to the hospital, throughout their time in intensive care, to release from the hospital and beyond. The case of 64-year-old Corazon Atienza demonstrates the impact of that approach.

“This case exemplifies and personifies the evolution of IHVI and the extraordinary services that have been amassed, coordinated and are being delivered here,” said Alan Speir, MD, Director of Cardiac Surgery, Director of Extracorporeal Membrane Oxygenation (ECMO) and Senior Associate Director of IHVI. “It’s not only about ECMO, transplant, ICU nursing or surgery. It’s about the transformation and coordination of these previously disparate services into a coordinated entity.”

Corazon came to Inova Fairfax Medical Campus’s emergency department on Jan. 21, 2022, with worsening chest pain and shortness of breath. The emergency team suspected she was in heart failure and was having a heart attack. She was admitted, the interventional cardiology team assessed her, and she underwent evaluation for possible angioplasty and stenting. Unfortunately, she was found to have complicated and advanced coronary artery disease and significant heart dysfunction.

Corazon remained hospitalized while undergoing evaluation for a left ventricular assist device (LVAD) and heart transplant. On Feb. 4, she suffered a cardiac arrest requiring resuscitation and was placed on venoarterial (VA) ECMO —  a machine used for critically ill  patients that temporarily supports the lungs and heart in order to provide oxygen and blood to the entire body).“The complexity of our patients is growing significantly, and we’re privileged to coordinate and provide therapies for them that weren’t available a couple of decades ago,” said Carolyn Rosner, NP, Director of Innovative Programs for IHVI.

Dependent on VA ECMO for life support, Corazon was now status 1 on the heart transplant list. Just 10 days later, on Valentine’s Day, Corazon received a heart transplant and was able to be removed from ECMO support. She had a challenging recovery, including suffering another cardiac arrest, requiring additional operations and two more days on ECMO support.

She was ultimately able to go to an acute rehabilitation facility to recover fully before going home on March 21. “I owe my second chance at life to the top-notch support and the technical skills of the whole Inova team,” Corazon said.

“Inova truly has an extraordinary approach to cardiac critical care, as seen in Mrs. Atienza’s story,” said Jessica Buchner, MD, ECMO Section Chief, IHVI. “Our system offers extremely specialized treatments for complex cardiac disease performed by a talented multidisciplined group that not only works together effectively but also does so with the utmost professionalism and humanity.”

Corazon spent a total of 59 days in the hospital and was on ECMO support for 10 of them. At IHVI, she had access to every complex intervention available. “Her case was complicated, and her odds of surviving if she had been anywhere else are likely very low,” said Rosner. “She really benefited from an integrated approach across medical specialties to coordinate her care. It allowed her to survive a heart attack and end-stage heart failure, and then be eligible for a heart transplant when it became clear that her heart had suffered too much damage.”

Today, Corazon and her husband, Pol, take long walks together – three to four miles each day. They look forward to traveling to their small farm in Florida soon and hope to go on a fishing trip to Alaska next May. “It’s a simple, but beautiful, life,” Corazon said.

“Corazon’s case is a great example of the extraordinary teamwork and excellence that takes place on a daily basis for us.” ~ Alan Speir, MD