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Tennessee doctors removed a man’s heart to save his life

MEMPHIS, Tenn. – In an extraordinary operation, a Mississippi man’s heart was removed and replaced with what Baptist Memorial Hospital doctors call a “total artificial heart” — battery-charged electromechanical devices that will keep the 41-year-old man’s blood pumping until a heart transplant can be arranged.



a person wearing a hat: Heart patient Brian Pedigo sits on a hospital bed at Baptist Memorial Hospital in Memphis, Tenn., on Wednesday, Oct. 7, 2020. Pedigo's heart was replaced with two ventricular assist devices and a breast implant.


© Ariel Cobbert/The Commercial Appeal
Heart patient Brian Pedigo sits on a hospital bed at Baptist Memorial Hospital in Memphis, Tenn., on Wednesday, Oct. 7, 2020. Pedigo’s heart was replaced with two ventricular assist devices and a breast implant.

Wearing a surgical-style mask decorated with an American flag and the motto “United We Stand,” artificial heart recipient Brian Pedigosaid Wednesday that his life since his first heart attack —which came “11 days before my 33rd birthday” — had been a constant struggle with heart disease, including a “massive” 2017 heart attack and the almost complete bodily shutdown that led to his Sept. 3 surgery at Baptist.

“I was close to giving up,” said Pedigo, who lives in Booneville, about 115 miles southeast off Memphis, with his wife, Amy Pedigo, their two dogs, Remington and Angel, and a pot-bellied pig named Sassy Mae, nicknamed Sassy Pants. (“She talks back to Brian, that’s why I call her Sassy Pants,” Amy explained.)

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Fortunately, the artificial heart — essentially, a pair of pumps that replace the removed ventricles of the heart  — has given Pedigo a new lease on life, literally.

“I feel great,” said Pedigo, sitting on the edge of a hospital bed. Unsurprisingly, he looked thin and sounded hoarse. “For the last eight years, I’ve fought, gone down and come back,” he said.



a man wearing glasses posing for the camera: Dr. Dmitry Yaranov, Pedigo's primary cardiologist at Baptist Memorial Hospital in Memphis, Tenn., on Wednesday, Oct. 7, 2020.


© Ariel Cobbert/ The Commercial Appeal
Dr. Dmitry Yaranov, Pedigo’s primary cardiologist at Baptist Memorial Hospital in Memphis, Tenn., on Wednesday, Oct. 7, 2020.

Dr. Dmitry Yaranov, Pedigo’s primary cardiologist at Baptist, said only about 15 operations of the type that saved Pedigo have been performed in history.

“This is the most complex, the rarest and the highest-risk operation a heart patient can go through,” he said. 

Also, “the most technically challenging,” said Dr. Rachel Harrison, the surgeon who performed the operation with Dr. Martin Strueber, Baptist chief of cardiac surgery and thoracic transplantation.

“It’s a very unconventional approach,” said Michelle Lorenz, administrative director of transplant services at Baptist. “But we had to do it to save his life.”

Pedigo had been receiving treatment in Corinth, Mississippi, before doctors there sent him to Vanderbilt University Medical Center. From there, he came to Memphis, where his failing health called for extreme measures. 



a person sitting on a table: Dr. Rachel Harrison, the surgeon who performed the operation with Dr. Martin Strueber, goes over a diagram of heart patient Brian Pedigo's surgery at Baptist Memorial Hospital in Memphis, Tenn., on Wednesday, Oct. 7, 2020. Pedigo's heart was replaced with two ventricular assist devices and a breast implant.


© Ariel Cobbert/ The Commercial Appeal
Dr. Rachel Harrison, the surgeon who performed the operation with Dr. Martin Strueber, goes over a diagram of heart patient Brian Pedigo’s surgery at Baptist Memorial Hospital in Memphis, Tenn., on Wednesday, Oct. 7, 2020. Pedigo’s heart was replaced with two ventricular assist devices and a breast implant.

“His lungs were no longer oxygenating his blood,” Harrison said. “His liver was

Treatment Reverses Young Man’s Type 1 Diabetes. Will It Last? | Health News

By Serena Gordon
HealthDay Reporter

(HealthDay)

WEDNESDAY, Oct. 7, 2020 (HealthDay News) — After starting a drug that’s officially approved to treat a type of blood cancer, a young man with type 1 diabetes was able to stop using insulin.

He’s been off insulin since August 2018 — more than two years.

Dr. Lisa Forbes — his doctor and co-author of a letter describing his case in the Oct. 8 issue of the New England Journal of Medicine — stopped short of calling the drug a cure for type 1 diabetes.

But Forbes, an assistant professor of pediatrics, immunology, allergy and rheumatology at Baylor College of Medicine in Houston, said the patient’s diabetes appears to have been reversed. She hopes it will stay that way as long as he keeps taking the oral medication called ruxolitinib (Jakafi). It’s in a class of medications known as JAK inhibitors.

Whether this drug can help others with type 1 diabetes isn’t yet known. This patient had a genetic mutation that ruxolitinib is known to work on. Forbes said it’s not clear if other people with type 1 diabetes also have this specific genetic mutation.

Type 1 diabetes is believed to be an autoimmune disease, though the exact cause is unknown. It develops when the immune system mistakenly attacks insulin-producing beta cells in the pancreas. Insulin is a hormone that ushers the sugars from foods into the body’s cells to be used as fuel.

People with type 1 diabetes produce little to no insulin and must take multiple daily injections of insulin (or use an insulin pump) to survive. No treatments are approved for reversing type 1 diabetes.

At 15, Forbes’ patient had been experiencing chronic yeast infections (of skin, nails, mouth and throat), chronic diarrhea, oral and rectal ulcers, recurrent sinus and lung infections and another autoimmune condition called hypogammaglobulinemia. At 17, he was diagnosed with type 1 diabetes.

Because he had multiple conditions, his doctors ordered whole genome sequencing to see if they could pinpoint a root cause. They saw one particular genetic mutation and thought ruxolitinib might help. He started the drug nine months after being diagnosed with type 1 diabetes.

“The drug had an unbelievable effect on his type 1 diabetes,” Forbes said. “A year after starting ruxolitinib, we took him off insulin, and he’s been insulin-free ever since.”

The patient is in college now, and Forbes said he calls the drug a “game-changer” because it’s a pill and so easy to take.

Forbes said this case provides potentially important information into a pathway that leads to type 1 diabetes. But more research is needed, she added.

Because ruxolitinib acts on the immune system, patients have a higher risk of certain infections. And their white blood cells, liver function and kidney function have to be checked every few months, according to Forbes.

She isn’t the only one excited about the potential of JAK inhibitors in type 1 diabetes.

JDRF (formerly the Juvenile Diabetes Research Foundation) has been funding research into