Extracorporeal membrane oxygenation (ECMO) is a sophisticated piece of equipment that takes over the function of the heart and lungs. It is used during open heart surgery, for heart failure patients awaiting a transplant, and premature infants, On March 25, UCLA Health system announced that ECMO had been used to save the life of a heart attack victim.
James Manzi arrived at Ronald Reagan UCLA Medical Center's emergency department in full cardiac arrest; the medical team tried everything to stabilize the 79-year-old heart attack victim, including shocking his heart 29 times with a defibrillator. In most cases, patients who suffer a heart attack as severe as Manzi's do not survive; only one out of every 10 individuals who suffer a cardiac arrest outside the hospital lives through the incident.
While the emergency department personnel attempted to restore Manzi’s heart rhythm, Dr. Eric Savitsky monitored Manzi's diminishing response to the resuscitation resuscitative efforts; he used a combination of bedside echocardiogram (ultrasound of the heart) and clinical signs. In view of the dire situation, he made an emergency request for ECMO. The use of the technology stabilized Manzi's heart; thus, allowing the cardiac team to transport him to the cardiac catheterization lab. Upon arrival, he underwent coronary angioplasty on an artery that was totally blocked. Following the procedure, the team placed a stent in the artery to keep it open; blood flow was completely restored.
Three days after his heart attack, Manzi's cardiac function recovered to the point that ECMO was no longer needed. Unfortunately, he had also suffered anoxic brain injury, which was the result of an inadequate supply of blood to his brain during the cardiac arrest––a common experience after such an event. However, after five weeks in UCLA’s intensive care unit, he was transferred to UCLA's neuro-rehabilation unit, where he completed his rehabilitation. The end result was an almost 100% recovery.
At a recent follow-up visit, cardiologist Dr. William Suh, who performed the cardiac procedures during the heart attack, confirmed that Manzi is doing remarkably well. Manzi expressed extreme gratitude to the cardiac and emergency teams that saved his life. He is now looking forward to his 80th birthday on April 6. The father of five children and six grandchildren explained, “I've always enjoyed my life and now appreciate it even more. Just being alive is wonderful.”
UCLA notes that only hospitals equipped to treat the most advanced cases have the ability to perform ECMO because the technology requires a multidisciplinary team of specialized physicians, nurses, and perfusionists. The minimally invasive procedure works by siphoning deoxygenated blood from a vein in the groin via a catheter, circulating that blood outside the body by means of a tube that passes through an oxygenator, then returning the newly-oxygenated blood to body through another catheter into an artery in the groin. “We are so pleased that this rare use of ECMO helped save Mr. Manzi's life,” noted Dr. Savitsky, a professor of emergency medicine at the David Geffen School of Medicine at UCLA and Ronald Reagan UCLA Medical Center. He added, “ECMO may be a viable option in very select heart attack patients who come to emergency rooms that are equipped to provide this therapy.”
Barbara Manzi, James wife of 23 years, said that once the doctors and nurses returned her husband to her, she was never going to let him go. She is very grateful to the UCLA team for saving his life and calls the nurses her “angels in green”––a reference to the color of their scrubs. James and Barbara first met at a bar mitzvah in Texas. James explained that it only took one dance and he was smitten. Just a few days later, he sent her three dozen yellow roses commemorating that first meeting in the Lone Star State, and they have been together ever since.