The Ironman of Inova: patient makes full recovery after 44 days on ECMO

Multidisciplinary care and teamwork at its finest

Steve Shelton, 35, of Martinsburg, WV, made Inova history when he broke the record for Inova’s longest-ever time on veno-arterial extracorporeal membrane oxygenation (VA ECMO). Steve was on VA ECMO for 44 days – 10 times longer than the average duration, providing a chance for his heart and lungs to recover. Even more impressive, Steve has made a remarkable recovery, returning home to his family and getting back to the daily activities he enjoys. “Just call me the Ironman of Inova,” he said.

Inova’s expertise in ECMO was recognized in January 2024, when our team received the prestigious Extracorporeal Life Support Organization (ELSO) Platinum Level Center of Excellence Award, the highest level of achievement in the field. The platinum designation is reserved for programs that have demonstrated the highest level of quality and infrastructure needed to provide exceptional care and superior outcomes for patients requiring extracorporeal life support. Steve’s story illustrates just how critical this is.

A life-threatening situation

Throughout the summer of 2023, Steve hadn’t been feeling well at all. His legs and feet were swollen, his toenails looked blue, he was losing vision in one eye, he couldn’t eat, and he felt extreme fatigue. Although he tried to keep going, Steve collapsed on July 14 and was taken to a local hospital, where the emergency team quickly realized that he was gravely ill. Steve needed the team at Inova Schar Heart and Vascular.

Steve was transferred to the Cardiac Intensive Care Unit (CICU) at Inova Schar Heart and Vascular — Fairfax Hospital, where he was diagnosed with right ventricular heart failure resulting from severe pulmonary hypertension.

“When Steve came in, he was very, very ill. Despite maximal efforts, he decompensated quickly and had to be resuscitated,” said pulmonary, critical care medicine and ECMO physician Junad Chowdhury, MD, who was involved in Steve’s care throughout his 67-day stay at Inova. “We called the Inova ECMO team for further support.”

A multidisciplinary team, an effective care plan

At Inova, the multidisciplinary ECMO team has representatives from advanced lung disease, advanced heart failure, cardiothoracic surgery, critical care and other disciplines dedicated to working together to determine whether ECMO is indicated and, if so, what the best ECMO strategy is. In Steve’s case, his heart and lungs were both extremely compromised, and the team decided that full support with VA ECMO would give his body the best chance to receive treatment and recover.

“Seeing our collaboration on such a critically ill patient is truly inspiring. At Inova, everyone has a seat at the table – doctors, therapists, nurses, dietitians and more. We have open discussions where anyone can bring up an idea, and it’s received and thoughtfully considered by the entire team,” said Sara Valenti, RN, BSN, CCRN, ECMO nurse coordinator at Inova Schar Heart and Vascular.

Over the next 44 days, Steve’s care team worked together diligently to find the right treatments for his pulmonary hypertension and see him safely through multiple complications including bleeding and blood clots in the lungs. He was too sick to be considered for a lung transplant – but over time, as Steve continued on ECMO, he began to rebound with aggressive medical therapy. On Aug. 29, Steve was successfully removed from ECMO support, and the whole team gathered to celebrate on Sept. 19, when Steve was discharged home.

“Steve’s story is such a good example of so many different providers coming together to contribute to his care and successful outcome, from the immediate team that first assessed him to the nurses, advanced practice providers, CICU team, surgeons, physical and occupational therapists, palliative care providers, and others,” said Carolyn Rosner, MSN, NP-C, MBA, Director of Innovative Programs at Inova Schar Heart and Vascular. “And today, he is not only surviving, he is thriving.”

One year later, Steve walked back into Inova Schar Heart and Vascular with a spring in his step and a smile on his face. He credits his faith, his family and his Inova team with his remarkable turnaround. “The doctors and nurses at Inova are amazing,” Steve said. “They’ll fight for you.”

“It’s cases like this that really make me love working here,” Dr. Chowdhury said. “Having the capabilities, the resources, the team, and the support of the health system, combined with our culture of open communication and collaboration with so many different people, makes Inova a very special place to work.”