Leaves crackle underfoot as Vicki Vergote follows a path through the woods to her deer blind.
“I can’t wait to get back here,” she says, as she reaches the arrangement of branches that form her hunting base.
She has left her crossbow at home. Today, Vergote has her sights set on recovering from a heart condition, rather than putting venison on the dinner table.
She recently became the first person in the U.S. to get an innovative new heart device. The U.S. Food and Drug Administration granted “compassionate use” approval to cardiologist Joseph Vettukattil, MD, so he could implant the device in Vergote’s ailing heart.
Dr. Vettukattil, co-director of the Congenital Heart Center at Spectrum Health Helen DeVos Children’s Hospital, has used the device several times in England, where he worked before coming to West Michigan.
But even in Europe, it is rare. Vergote was only the 40th patient in the world to receive it.
Vergote, a 56-year-old woman who lives in Canadian Lakes, Michigan, followed a winding path to her status of “U.S.-medical first.”
About eight years ago, during a bout with bronchitis, her doctor told her she had pulmonary hypertension, a chronic condition that causes high blood pressure in the lungs.
“He said it’s life-threatening and you will never get rid of it,” Vergote recalls.
She took medication to reduce the pressure in her lungs, and she continued working and caring for her family and staying active. But in the summer of 2015, she began to experience episodes where her heart raced. Her doctor referred her to heart specialists at Spectrum Health.
After a multitude of tests, Vergote learned in October 2015 that she had an atrial septal defect―a hole between the right and left atria, the upper chambers of her heart. The opening allowed extra blood to get pumped to her lungs, and that caused high pressure in the lungs.
The hole measured 27 millimeters, just over an inch. A congenital heart defect, it had been there all her life.
The diagnosis shocked Vergote and her husband, Bruce, because she had always been such an active person―a camper, hiker and backpacker. She had already hunted three days that season. She had just bought new teal camouflage gear and couldn’t wait to use it.
“There’s just something about being in the woods,” Vergote said. “Memories of my dad and enjoying God’s country. I love the outdoors. I love nature.”
She asked her cardiologist if it was safe to keep hunting. She uses a compound bow, pulling 35 pounds.
“Absolutely not,” the cardiologist replied.
‘A safety valve’
In the coming months, Vergote’s condition grew worse. She got winded climbing the steps to her house. She couldn’t carry groceries without losing breath. She had to give up dancing with friends on karaoke night at the local bar.
In January 2016, through a referral from Dr. Girgis, she met with Dr. Vettukattil, hoping for a fix that would restore her quality of life.
Her condition posed a challenge because it appeared both lung disease and the heart defect contributed to the pulmonary hypertension. Dr. Vettukattil worried that if he closed the hole in her heart completely and the pressure in the lungs became worse, that would put pressure on the right atrium, ultimately leading to heart failure.
It’s been a lot to learn about, a lot to absorb and a lot to be thankful for.
He suggested trying a new device―the Figulla flex fenestrated atrial septal defect device―produced by a Swiss company, Occlutech.
The round mesh device would be implanted in Vergote’s heart to close the hole between the two upper chambers. But it would not close the gap completely.
The device includes a small hole, about 6 millimeters, or roughly a quarter of an inch, that would allow some blood to pass between the right and left atria. That could provide relief if there is a build-up of pressure on the right side of the heart.
“It is a safety valve,” Dr. Vettukattil says.
Before the procedure, a multidisciplinary team discussed Vergote’s case, because she had severe pulmonary hypertension, was on maximal medical therapy and surgical intervention was ruled out.
The team determined the fenestrated device was the only therapy that might be able to help her.
Vergote agreed to the procedure, eager to find a solution that would extend her life and improve her quality of life.
“It was truly a team effort to make this possible,” Dr. Vettukattil says.
On Sept. 21 at Helen DeVos Children’s Hospital, he implanted the device, working closely with a catheterization lab team.
By drastically narrowing the hole in the heart, the device boosted the amount of blood pumped from the left side of the heart to the body.
“The amount of blood that is ejected by the heart went up by almost 70 percent,” Dr. Vettukattil says.
Increased cardiac output means greater capacity to exercise or do physical activity―such as climbing stairs or hunting.
Monitoring her condition over time, he will watch to see if pressure in the lung arteries falls.
“Then, as the pressure starts falling, we can go back and close the residual hole,” he says.
‘She’s my best friend’
On Oct. 25, a month after she received the implant, Vergote returns for a checkup. She is feeling stronger, able to do more without getting winded.
Tests show the oxygen saturation is in the mid-90 percent range when she exercises. That’s far better than before the device, when it would drop into the mid-80s.
Dr. Vettukattil tells her an echocardiogram shows good device placement, improved pressure in her lung arteries and shunting from the left to the right side of her heart. All this means the device therapy may halt or slow progression of her pulmonary hypertension.
And then he tells her the news she longs to hear: She can resume full activities. Vergotte covers her face, overcome with emotion. She holds out her hand and gives Dr. Vettukattil a high-five.
At home that afternoon, she takes out her bow and shoots four arrows at a hay bale. Her aim needs work and she needs to build strength, but it feels good. That weekend, she and Bruce go hunting together for the first time in a year.
The medical journey of the last year and a half caused a major life shift for the couple, married 30 years.
“Everything was about work,” says Bruce, a welder who has owned several businesses. “You see all the challenges and you see all the problems, but you don’t see all the blessings that you have.”
When he learned of his wife’s heart condition, it stopped him in his tracks. A fixer, it grieved him to know she faced a problem he could not fix. Seeing her coming out of the procedure feeling stronger gives him hope.
“She’s my best friend,” he says. “We do everything together. And she just loves everything. She’s very giving. She’d give the shirt off her back for anybody. She deserves this.”
Now, both are counting their blessings. And they are looking toward the future.
“I feel great,” Vergote says. “I am on top of the world.”
Although her heart condition derailed Vergote’s plan to open a gift shop, she now plans to create crafts and jewelry. She looks forward to spending time with her two adult children and her first grandson, a bouncing baby boy named Gunnar.
“It’s been a lot to learn about, a lot to absorb and a lot to be thankful for,” Vergote says. “My faith has gotten me through this. I’ve just given it all to God.”