When Anthony Guacci walked into Atrium Health Carolinas Medical Center last fall, he had no idea how close he was to the end — or to a new beginning.
After weeks of fatigue and shortness of breath, tests showed his heart was failing fast. His heart’s function had plummeted, and within days he was on full life support.
“I came in for a right heart catheterization and my pressures were low — my EF was super low,” Guacci said. “They admitted me right away. Within a few weeks I was on the transplant list. The team was just phenomenal.”
An ejection fraction (EF) measures how well the heart pumps blood with each beat. A normal EF is between 50% and 70%. Guacci’s had dropped dangerously low, meaning his heart could no longer circulate enough blood to sustain his organs.
To keep him alive, his care team used temporary mechanical heart pumps. The first pump was a small device inserted through a blood vessel that helps the heart move blood to the body. When his condition worsened, he was placed on ECMO (extracorporeal membrane oxygenation) — a machine that temporarily takes over the work of both the heart and lungs, giving them time to rest while awaiting a transplant.
That “team” — spanning cardiology, cardiac surgery and critical care — represents a system Dr. Joseph Mishkin, medical director of advanced heart failure at Atrium Health Sanger Heart & Vascular Institute describes as “a network designed to meet patients where they are.”
“We’ve created a system of care around heart failure in all its phases,” Dr. Mishkin said. “Community cardiologists can reach us instantly — literally at the touch of a button — through our transfer network. From that moment, the entire Sanger team engages: stabilizing the patient, exploring long-term options and educating families every step of the way.”
That system has helped make Atrium Health Sanger Heart & Vascular Institute one of the nation’s leading heart centers — now the third-largest VAD center and 18th-largest heart transplant program in the country. This year alone, Sanger has performed 64 VAD implants, 62 heart transplants and provided 126 advanced heart therapies, with more than 700 patients under care.
A ventricular assist device (VAD) is a small mechanical pump that supports the heart when it can no longer pump blood effectively on its own. It can serve as a bridge to transplant for patients waiting for a donor heart or as long-term therapy for those who aren’t transplant candidates — allowing them to return home, regain strength and enjoy a better quality of life.
A day of celebration — and new life
On Nov. 2, 2024, while teammates and families gathered for Sanger’s annual Celebration of Life honoring transplant and VAD recipients whose lives have been renewed, a different kind of celebration was unfolding across the street.
In a nearby operating room, Dr. Eric Skipper and his surgical team were preparing to perform another heart transplant — Anthony Guacci’s.
“Transplants are unpredictable,” Dr. Skipper said. “They happen when they happen — and this one happened on the very day we were honoring others whose lives had been transformed by transplant and LVAD therapy. Seeing Anthony doing so well now makes it even more special.”
Guacci awoke to a new heartbeat — and an entirely new life.
“I didn’t even realize until this year that my surgery happened during that event,” he said, smiling. “To think I was receiving my new heart the same day others were celebrating theirs — that’s powerful. Coming back this year, seeing all those people, it just lifted my spirits.”
Life after transplant
Now a year later after this transplant, Guacci says he feels stronger and more grateful than ever.
“I take this gift very seriously — to honor my donor and live my life to the fullest for my family,” he said. “Every day feels like a blessing.”
As Sanger continues to expand its advanced heart failure network — bringing lifesaving therapies to more patients across the Southeast — stories like Guacci’s reflect the promise of modern medicine and the power of connection.
“For me, the Celebration of Life is really a lesson in resilience,” Dr. Mishkin said. “It reminds all of us why we do what we do — and how much light there can be on the other side.”
