RETURNS THU JAN 19 8|7c

Living Without a Heart?

By Meg Marinis, Director of Research | Nov 19th, 2009
A lot of people take their heartbeat for granted. They know it's there. They can put their hands over their chest and feel it beat. They can place a fingertip over their carotid or inside of their wrist and catch their pulse. They feel it speed up when they exercise or get scared. They feel it slow down when they rest.

Not Kelsey.

In Episode 610 Holidaze, poor Kelsey thought that she and Mike had plans for a fourth date. However, instead, she woke up a day later at Seattle Grace attached to a machine the size of a photocopier. And without her new heart.

Why did Kelsey have a heart transplant in the first place?

Before receiving a new heart, Kelsey suffered from cardiomyopathy—a disease that causes the heart muscle to become enlarged, or thickened. When this disease takes over, the heart cannot function as well—the heart becomes less able to pump blood throughout the body. This leads to several serious complications such as heart failure, abnormal heart rhythms, fluid build up, and pericarditis—inflammation of the heart's lining.

Some people may never even know they have an enlarged heart; unfortunately, for others, their symptoms may become quite severe, necessitating treatment, sometimes even an entire transplant (such as Kelsey's case).

And why did they take the new heart OUT?

Right before we see Kelsey onscreen in the OR at the very beginning of the episode, she came into the ER with congestive heart failure of her newly transplanted heart. They found out Kelsey had a "pseudo-aneurysm" at the suture lines of the transplant. (A pseudo-aneurysm is a leakage of blood from an artery into the surrounding tissue that may form a hematoma).

When Cristina, Teddy, and Jackson opened Kelsey up to repair the problem, they had a horrible finding—the heart tissue had started to die so quickly that it did not even resemble a heart anymore. They had no time, so Teddy did the only thing she could do: take the damaged heart out completely.

So, how exactly did her body still pump blood?

Teddy connected two artificial pumping devices to Kelsey's blood vessels to and from her heart. Usually, without removing the heart, surgeons insert a ventricular assist device with the heart still in place; however, Teddy does things a little differently at Seattle Grace! Therefore, Kelsey's pumping devices are attached to the large console unit (the huge machine that you can see outside with her in the snow) that controls the circulation.

How long could someone live without a heart in their body?

Kelsey remained connected to the devices for approximately six weeks throughout the holidays. However, there has been an instance of a patient enduring it for four months. The psychological impact just takes a toll on the patient—Kelsey admits to her fatigue and desire to be outside in the snow, wanting to be out of the hospital bed. Now patients can be mobile, as we saw Kelsey take a trip to the ambulance bay, but she needs to stay within two feet of the console at most, due to the fairly short lines of the devices, and she can only be up and about for about an hour, because the batteries only last for about an hour when they unplug the machine.

For more information on cardiomyopathy, please visit:

http://www.nlm.nih.gov/medlineplus/cardiomyopathy.html

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