ANN ARBOR, MI — April Hogan went into more than 25 cardiac arrests about 18 months ago.
She had a severe blockage in the left coronary arteries of her heart, a condition known as acute left ventricular thrombosis. Most patients in her condition would not survive, said cardiothoracic surgeon Dr. Ashraf Abou el ela of the University of Michigan Frankel Cardiovascular Center.
“We don’t usually see patients like this,” he said. “They actually drop dead. Somehow this patient made it to the hospital.
Amazingly, Hogan, 39, from Ypsilanti, is still alive. This is thanks to the work of Abou el ela and modern cardiovascular treatments available at the University of Michigan health system, she said.
“I wouldn’t be here today without Michigan Medicine,” Hogan said.
Hogan was told she had heart problems in 2021, but one day in July she said she was hot and out of breath.
“Nothing hurt,” she said. “My heart didn’t hurt and I wasn’t in pain. I felt really dizzy and felt like I was going to pass out. I never thought I was having a heart attack.”
Hogan was first taken to Trinity Health Ann Arbor Hospital by her husband, Andre Smith. When doctors there realized the seriousness of her condition, she said she was rushed to Michigan Medicine by ambulance.
When she awoke three days later, Hogan said doctors had told her she had suffered 25 cardiac arrests, adding that she could have had as many as 35.
The solution that saved her life is known as extracorporeal membrane oxygenation, or ECMO. It’s a process in which blood is sent to a machine that oxygenates it before pumping it to the rest of the body’s vital organs, Michigan Medicine officials said.
Basically, ECMO calms failing hearts with the help of the machine. In Hogan’s case, it gave Abou el ela and fellow doctors time to find a longer-term solution, he said.
“When someone goes into cardiac arrest, especially as often as they do, we have a lot of things to figure out,” he said. “Is the brain functioning? Will the kidney work? So once we initiated ECMO and supported the heart, we bought time to evaluate her for advanced surgical therapies for heart failure.
The final solution was an LVAD, or left ventricular assist device, that improved blood circulation throughout the body, Abou el ela said. This kept Hogan alive while she was on a waiting list for a new heart.
“We were able to get the rest of the body to function, such as the kidneys, liver and lungs,” Abou el ela said. “And we kept them in shape long enough to have open-heart surgery.”
Hogan woke up three days later, both literally and in the sense that she had to change her way of life.
“It woke me up to a lot of things — to pay more attention to my health,” she said.
Living with an LVAD kept Hogan in her home most of the time, she said. She had to carry the device with her everywhere, as well as batteries and spare parts in a bag.
“I was really depressed about it,” she said. “Very remote.”
She gave up drinking and smoking, she said, because that “caused everything” with her heart problems. She even said she had to sign a contract promising to quit smoking to get a new heart.
In early August, Hogan jumped on the waiting list for a heart transplant because of an infection from her LVAD. The surgery was successful and she is back working at her retail job and is starting to live parts of the life she had prior to her cardiac arrest.
“I’m starting to get back into the groove of things,” Hogan said, adding that she’s now exercising and eating healthy by avoiding cookies.
Getting Hogan to this place “it took a village,” Abou el ela said, crediting his surgery team, as well as the organ procurement and transplant teams. Her recovery is now the best kind — calm and smooth, he said.
Two years ago, Hogan said she didn’t even know she had a heart problem. Now she plans to spend the rest of her life acutely aware of it, determined to be healthy.
“It confused me. It scared me,” she said. “But now I’m just trying to keep going and keep my health better.”
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