Victory on the Home Front
All the way from Kosovo: A U.S. Army specialist with rapidly declining heart function due to infection was transferred via Macedonia, then Germany, then Walter Reed Medical Center, and finally to Inova to receive life-saving care. The extracorporeal membrane oxygenation (ECMO) machine took the burden off his heart and lungs while Inova’s cardiac experts worked to strengthen his heart function.
As Charles Furstenberg trekked along a 12-mile trail in the early Kosovo dawn one day last April, a 35-pound rucksack digging into his shoulders, he kept pace with his fellow soldiers as they marched the hilly path through the darkness. The 3 a.m. drill, designed to test his strength and endurance, was routine for the U.S. Army specialist, who was accustomed to pushing his physical limits.
But later that night, the 25-year-old Texan faced another battle. As if his body had come under fire by an unseen enemy, Charles was hit by a wave of nausea, vomiting and endless bouts of shivering. He was quickly placed under close medical supervision, but over the next few days, his health spiraled downward and his body convulsed with seizures.
From Kosovo to Northern Virginia
Charles was flown by medevac to a civilian hospital in Macedonia where an echocardiogram revealed his heart wasn’t functioning at full capacity. To combat his abnormally low blood pressure, doctors prescribed inotropes, a medication to strengthen the force of his heartbeat. But when his condition worsened, he was transported to Lanstuhl Regional Medical Center in Germany, where doctors implanted a temporary pacemaker to keep his heart beating. As Charles’ heart began to fail, he was transported to Walter Reed National Military Medical Center, near the nation’s capital. Within an hour, he was rushed in an ambulance to Inova Heart and Vascular Institute (IHVI) at Inova Fairfax Medical Campus (IFMC), where a team of cardiac specialists was ready to provide him with urgent, lifesaving care.
“When Charles arrived at Inova, he was in acute cardiogenic shock caused by viral myocarditis, an infection of the heart. His heart was failing and unable to pump blood to the rest of his body. He was also experiencing kidney and liver failure and had poor blood flow to the brain,” says Charles Murphy, MD, Director of the Cardiovascular Intensive Care Unit (CVICU) at IFMC.
The “ECMO” machine: a life-saving device
Despite Charles’ condition when he arrived at Inova, Dr. Murphy was confident his team could give Charles the care he needed to restore his failing heart. Within minutes, the team placed Charles on extracorporeal membrane oxygenation (ECMO), a machine that would take the burden off his heart and lungs, ultimately saving his life.
“Our team placed Charles on veno-arterial ECMO,” says Dr. Murphy. “This involves taking blood from a vein and running it through an oxygenator that restores oxygen and removes carbon dioxide. The blood is then pumped back into an artery. ECMO takes over the function of the heart and lungs.”
As Charles faded in and out of consciousness, surrounded by family and a highly specialized, caring medical staff, he sensed he had come to the right place. “I knew I was in good hands,” says Charles. “Every time the nurses and doctors came in they answered any questions my mom or I had, and they would always tell us what was going on, how my heart was recovering and what kind of shape I was in. They were very helpful.”
From ECMO to Impella heart pump
About a week later, Charles was taken off ECMO, and the doctors at IHVI implanted an Impella heart pump in his chest, a small device that would maintain his heart function for the next 10 days as he began to recover. After two more weeks, Charles was transferred back to Walter Reed where he joined the Warrior Transition Unit.
Next step: cardiac rehab at Walter Reed
These days, Charles is back to taking long treks; only now it’s to sightsee with his family. Over the next year, while he completes cardiac rehab at Walter Reed, he plans to pursue an academic degree and an internship. Once his heart function is restored, he aspires to return to active duty with his battalion stationed in Kentucky. He also hopes to pursue ice hockey again, a favorite hobby.
“Charles’ prognosis is excellent,” says Dr. Murphy. “My expectation is he should have a normal life moving forward. He was in peak fitness so this could set him back in terms of the timeline, but I hope he will accomplish anything he wants to in the military.”
For right now, Charles is happy to be near home, surrounded by family and friends. “The whole experience was scary at first, but I trusted the military to get me where I needed to be; I trusted all the medical teams that I met; and I had my family to help me through it,” says Charles.
Dr. Murphy couldn’t be more pleased with his outcome.
“This is a great success story,” he says. “Our team is very thrilled to be able to help out someone on active duty. Our military deserves our very best healthcare, and to be able to participate in that is very gratifying for us.”
What is ECMO?
For patients with heart or lung failure, extracorporeal membrane oxygenation (ECMO) takes over the work of pumping blood through the body. Candidates for ECMO include patients with acute heart failure caused by a virus or a heart attack; chronic heart failure caused by coronary artery disease or non-ischemic cardiomyopathy; or lung failure caused by cystic fibrosis or a respiratory disease such as pneumonia. It can also be used as a bridge to recovery for patients with heart or lung transplants.
Inova Fairfax Medical Campus expanded the ECMO program over the last two years and now offers a full range of ECMO services to adults and children. The team of cardiac specialists includes heart surgeons, cardiologists, intensivists, ICU nurses, OR nurses, respiratory therapists, ECMO specialists, advanced practice providers and perfusionists. “We serve patients as young as the neonatal age group to adults, and we’ve had multiple successes,” says Dr. Murphy.