Modesto hospital uses miniature heart pump to save mother’s life after cardiac arrest

Gisel Tafolla is enjoying the happy times of raising her baby daughter, just three months after surviving a harrowing medical emergency.

The 26-year-old Delhi mother gives credit to the lifesaving measures of medical professionals at Emanuel hospital in Turlock and Doctors Medical Center in Modesto — and to what’s known as the world’s smallest heart pump.

Gisel arrived at 5:30 a.m. July 26 at the Turlock hospital for a routine gallbladder operation, but things went terribly wrong because of a rare heart condition she didn’t know about. She was airlifted to the Modesto hospital around 1 p.m.

“I believe I had like four heart attacks,” Gisel said. “They were trying to stabilize my heart for about an hour at Emanuel. I am extremely grateful for the doctors and nurses that helped me through my recovery.”

A hospital spokesman said Gisel suddenly went into cardiac arrest as the surgery was beginning at Emanuel. Her husband, Jesus, had last seen her in the pre-op area and was watching the color-coded rectangles on the waiting room board to monitor his wife’s progress.

“It never changed to the next step,” said Jesus, a manager for Amazon. Two hours passed and then two doctors came out and said his wife’s heart had stopped. Jesus was told they tried for 40 minutes to resuscitate the woman, restored a heart beat and she was now in intensive care awaiting transfer to another hospital.

“It was hard to believe,” Jesus said. “I felt it couldn’t be real.”

Gisel remembers waking up once during the medical emergency at Emanuel and seeing her husband, their baby daughter, her mother, two sisters and a priest summoned by the family.

An ultrasound of her heart showed it was beating but not producing enough blood flow to her organs, said Dr. Zachary Brewer, a cardiothoracic surgeon at DMC, who would oversee her care over the next few days.

Doctors Medical Center told Emanuel’s staff it was able to accept the critically ill patient, so she was flown to the Modesto hospital. Brewer was soon at the bedside with an intensive care physician, and they quickly evaluated Gisel’s condition.

Gisel was in what’s known as cardiogenic shock, which means insufficient blood was getting to her brain and other vital organs. “Her blood pressure was low,” Brewer said. “If it keeps going like that, the body’s organs will shut down because they’re not getting enough blood flow.”

Gisel was taken to a hybrid operating room at DMC where doctors had access to multiple technologies to support the patient. Brewer considered putting the young woman on the ECMO, a portable heart and lung machine, but that comes with complications and disadvantages such as putting the patient on a ventilator, which would keep her from walking during recovery.

Brewer recommended a small heart pump called Impella to assist with improving blood flow while allowing Gisel to rest and recover. The pump was installed through a small incision under her collarbone and threaded through an artery to her heart.

“Her function improved dramatically and we were able to wean her from (high doses) of toxic drugs that were keeping her blood pressure up,” Brewer said. “We thought she may have to be transferred to another facility and be a candidate for a heart transplant.”

Jesus said the doctor explained the options, but at that point he had no way of knowing if his wife had suffered severe damage to her brain or other organs, whether the treatment would work or if she would pull through.

“It was the best way of supporting her heart and jump-starting it almost,” Jesus said. “They were going to do the best, but we had no idea what the outcome might be.”

Brewer said the patient’s heart was engorged and inflated like a balloon. The Impella pump takes blood in the left ventricle of the heart and pumps it across to the aorta, which circulates the blood to the rest of the body. In 2021, use of the heart pump at DMC was instrumental in saving the life of Sandra Villasenor, then principal of Grayson Elementary School in western Stanislaus County.

In Gisel’s case, the miniature pump allowed the heart muscle to rest and recover. Gisel was on the pump for three days before it was removed.

When Gisel regained full consciousness July 28, she said, she didn’t know she was in a different hospital until reading “Doctors Medical Center” on top of the whiteboard displaying the to-do list in her room.

She didn’t recognize the smiling nurses who popped into the room and saw her awake for the first time, after caring for her during the life-or-death struggle. She soon bonded with the staff in the hospital wing, who cheered for her when she took her first steps.

People stricken with cardiac arrest on the street have a high mortality if they don’t receive immediate medical attention. The chances of survival are higher if it occurs in a hospital. Gisel was released home after 12 days of hospital care.

Rare heart condition was the cause

Gisel had postpartum cardiomyopathy, a rare condition that happens after birth in a small percentage of pregnancies. This rare type of heart failure starts in the last month of pregnancy or within five months after the birth. With treatment, more than 50% of patients recover in less than six months, according to the Cleveland Clinic site.

The heart becomes enlarged and other symptoms may include shortness of breath and swelling of the extremities, which may be similar to symptoms of pregnancy. The condition is even more rare in women younger than 30.

Gisel said she had swollen feet after giving birth to her daughter, Sophia, and she experienced fatigue. “I thought I was tired from taking care of a baby,” she said.

Gisel developed sharp pains from gallbladder flareups and was referred to a specialist, who said she had gallstones. Postpartum cardiomyopathy is not well understood and the signs may not be noticed in a screening before surgery.

Gisel has been told she can’t have more babies and to follow restrictions such as no alcoholic beverages. She is taking medications for blood pressure and a blood clot that put her back in the hospital for one day. She said she watches her diet and avoids spicy foods to prevent gallbladder flareups.

It has meant some lifestyle changes for a woman who used to carry several gallons of milk as a Starbucks employee and once ran a half marathon.

“I have learned to slow down,” Gisel said and talked about the moments of cuddling her child and making funny noises to make the baby laugh.

Brewer said the hospital uses the Impella pump several times a month, oftentimes to support patients who had high-risk heart surgery.

He said it’s not often used for younger adults but resulted in a faster recovery for Gisel and allowed her to keep her natural heart.