In July 2010, Rajwant Sandhu rushed to her local hospital complaining of chest pains. The physician’s assistant who checked her out in her local emergency room near Poughkeepsie told her that she was just stressed out. After all, she was a healthy 20-year-old with no family history of heart disease, and she was in the middle of studying for medical college entrance examinations.
But her symptoms worsened. Her frantic parents called 911. When they arrived, the EMTs performed an echocardiogram and were so shocked by what they found that they repeated it twice more: Sandhu was having a massive heart attack. Interventional cardiologists at the local hospital placed a stent, but Sandhu’s condition was so dire that she needed more expert care.
She was rushed by ambulance to Columbia, where Ulrich Jorde, MD, medical director of the Cardiac Assist Device Program, and his team performed open-heart surgery to place a left ventricular assist device (LVAD). Sendhu’s failing heart was too damaged to recover, so the LVAD would serve as a “bridge,” keeping it functioning until a transplant could be found.
“My chances were very slim, even with the LVAD,” Sandhu says. “They told my family to say their goodbyes before I went into surgery.”
But Sandhu fought back, and in late August, after spending several weeks recovering at Columbia, she went home to Poughkeepsie to wait for the call that would tell her a new heart was available. Before that call could come, she was hit with another setback—a stroke.
Sandhu spent three more months at Columbia, battling a brain hemorrhage and struggling to get her speech and control of her body back. As she was going through rehabilitation for her stroke, the LVAD became clogged and had to be removed. Dr. Jorde and his team decided not to place another LVAD, and instead sent Sandhu home in November hooked up to an external defibrillator.
“At first I was depressed and I didn’t want to eat, but I was determined to see how much I could recover, so I kept pushing myself in occupational therapy and speech therapy,” she says.
By January 2011, Sandhu was strong enough to go back on the transplant list. On May 11, she got the call: there was a new heart for her. The surgery went well, and she spent only two weeks in the hospital afterward. In the fall of 2012, she started back to school at the College of New Rochelle, and that December, she and her fiancé were married. “My ejection fraction is now 75%--which is above average. The doctors joke that my heart is like a Ferrari engine now.”
Sandhu’s plans for a medical career were derailed by her own medical crisis, but she remains committed to shaping the future of medicine and science. After graduating from the College of New Rochelle Magna Cum Laude with double BS degrees in biology and chemistry in the spring of 2013, she became the first recipient of a scholarship from the Ruth L. Gottesman Math & Science Education Scholarship Fund, which will fully fund her education at Columbia Teacher’s College. She is pursuing an M.A. in Science Education, specializing in 7th through 12th grade Biology.
Rebecca Kuffour is a fighter. The home health aide first battled breast cancer in her early 30s, when the youngest of her three children was just a baby. She underwent chemotherapy and a mastectomy, and for seven years thought that the cancer had been defeated. She continued working and raising her kids in their Brooklyn home—and even had another child.
But in 2009, when her youngest was just a year old, a regular blood test revealed that her cancer had returned, and spread to her liver. She began regular treatments with the targeted therapy Herceptin, which helped to keep the spreading cancer at bay. That control came at a price, however. In some cases, Herceptin can do serious damage to the heart’s ability to function. Rebecca was one of those cases.
The longer she was on the drug, the weaker she felt. “At first, I just thought I was a little run down from going through treatment and taking care of my kids and everything,” she says. “I thought it was nothing serious.”
In April of 2013, it got serious. She could barely breathe, and couldn’t even go up a few steps. When she was hospitalized, Rebecca’s ejection fraction—the volume of blood that the heart pumps out to nourish the body with each beat—had fallen to just 10%. A normal, healthy heart pumps at least five times that much.
It turned out that Rebecca had been hospitalized at just the right time: Columbia’s Division of Cardiology had just created The Center for CardioOncology. This program specializes in providing cardiac care for cancer patients and cancer survivors and is one of only about a dozen or so in the nation.
Caring for patients like Rebecca is a fine balance to strike, says Daniel O’Connor, M.D., Ph.D. “When she was admitted to the hospital, she was critically ill with heart failure and it took several weeks for her to really improve clinically. Today, her ejection fraction is up to 25%. Unfortunately, she is unable to continue Herceptin; however, working in close collaboration with her oncologist we have chosen a different chemotherapy that is safer for her heart. A major goal of this program is to keep people on chemotherapy while minimizing the cardiac damage.”
Rosellen Smith was about to become a grandmother for the third time. But as she met her daughter at the train station for an afternoon of window-shopping as they awaited the birth, she collapsed.
By the time they reached a local community hospital, Rosellen— who had already suffered a heart attack in 2002 and endured a triple bypass in 2009—was hypotensive and in cardiogenic shock. Her damaged heart could no longer pump enough blood to meet her body’s basic needs. She was dying, and dying fast. Her only hope was a transfer to the Milstein Family Heart Center at Columbia—the only hospital in the area that had the technology and expertise to save her life.
When LeRoy Rabbani, MD, Director of the Cardiac Intensive Care Units and Cardiac Inpatient Services at Columbia University Medical Center Rabbani began working on Rosellen in the cardiac catheterization lab at Columbia’s Milstein Family Heart Center, he knew that even a world-class institution like Columbia—named the third-best cardiology program in the nation in 2013—faced tremendous odds against saving her life.
“Her right coronary artery was 100% blocked,” he recalls. "We used a newer-generation drug-eluting stent to open the artery. But as we were opening it, she began to go into a life-threatening arrhythmia called ventricular tachycardia.”
For more than an hour, Dr. Rabbani and his colleagues—including interventional cardiologist Susheel Kodali, MD, and cross-trained cardiothoracic surgeon and interventional cardiologist Isaac George, M.D.—fought to bring Rosellen’s heart back to a normal sinus rhythm. All through that time, two nurses tirelessly administered CPR, maintaining vital blood and oxygen flow to Rosellen’s body and brain. Finally, the team was able to insert a percutaneous left ventricular assist device to pump for the left side of her heart. At the same time, they used veno-arterial extracorporeal membrane oxygenation (ECMO), to perform work outside the body that the damaged heart could not do itself, supporting both her blood pressure and her breathing. At last, Rosellen’s heart rhythm was back to something resembling normal.
The next day, cardiothoracic surgeon Hiroo Takayama, MD, placed a new biventricular assist device to help Rosellen’s heart continue to recover as she lay in the cardiac ICU, receiving hypothermia treatment to cool her body and protect her brain. Weeks later, when the device was removed, Dr. Rabbani was surprised to see that Rosellen’s ventricular function had returned almost to normal.
After another month, she was discharged from the Family Heart Center to a rehabilitation hospital, where she was finally able to hold her newest grandson. Today, vital as ever, she is back in her home. “She has a long road ahead of her but she’s got a new outlook on life, a new commitment to being healthy. And we have the doctors, nurses and the whole team at Columbia to thank for that,” says her daughter.