Unopen heart surgery

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by Jay Crandall

azfamily.com

Posted on April 12, 2013 at 3:26 PM

Updated Friday, Apr 12 at 3:29 PM

PHOENIX -- There is no question heart surgery is a big deal, but now, more than ever, when doctors heal the heart, they are thinking small.

“We have some fancy, expensive gadgets here to show you guys,” said Dr. Ashish Pershad at Banner Good Samaritan Hospital. And while at first glance those fancy gadgets look as much like toys as anything else, from a mini lariat to a little balloon, they are actually the new tools of the trade for heart surgery.

“The goal being to spare the patient the sawing of the sternum,” Peshad said, “because that is really the most troublesome and the hardest part of open heart surgery.”

And all of the little tools mean for many patients open heart surgery is now unopen.

“I don't have a big zipper in the chest to show we were in there, but we were in there, we were operating from the inside out,“ Dr. Wilber Su said.

From inside your heart, Su can correct atrial fibrillations, an irregular heartbeat that can be caused by abnormal bits of tissue sending out erratic electrical signals.

“The rogue areas, if you will, that are causing trouble, we can identify them and freeze them off, “ Su said.

To reach into the heart, he threads a thin catheter up through a vein in your groin. Those veins can be as small in diameter as an average drinking straw, but they get doctors where they need to go.

“We actually typically go through the groin vein because it is a direct conduit to the heart,” Su said.

But on the end of the catheter, the business end, as Su likes to say, is a small collapsed ballon, but once inside your heart, Su fills it with freezing gas.

“After the balloon is inflated and engaged in the vein then this refrigerant is delivered through the catheter itself into the tip of it,” he said.

The refrigerant freezes problem areas, wiping out a leading indicator for strokes, all with less discomfort and danger to patients.

”So what used to take me eight hours to do, now takes me about an hour,” Su said. “What used to take an hour of X-ray exposure, now is unbelievably low, maybe two or three minutes.”

And that is just the beginning of how micro surgery is keeping chests closed while healing hearts.

“Closing of holes in the upper chambers of the heart -- those are the relatively simple ones that have been around for a decade,” Pershad said.

To do that doctors again feed a catheter through the vein.

"And we deploy it across the hole coming from the groin in this way and we are able to close the hole in the upper chamber successfully," Pershad said.

And Banner Good Sam is a leading hospital in replacing heart valves, the same way ... a metal frame holds an actual valve. That frame squeezes small enough to fit through a vein then pops open in the heart.

As Pershad explains, “This stays in the aorta and the valve itself sits in the location of the old valve.”

And as the tools are refined even more, Pershad said doctors are now able to save more lives with less heartache every day.

“I would say 90 percent of the patients are back to work in five to seven days with no recollection of what happened,” he said.
 

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