High-risk cardiac patient who was “out of options” gets treatment

July 19, 2016 | by Edward-Elmhurst Health
Categories: Healthy Driven Hearts

Helen Vaux, 82, suffered a heart attack in March 2016 while at a family wedding reception in Florida. "I started to feel very tired and my chest was making strange noises when I lay down," recalls Vaux. She was taken to a local hospital where she had a cardiac catheterization, a procedure used to diagnose and sometimes treat heart conditions.

Though the test showed significant blockages in three of Vaux's coronary arteries, doctors told her there was nothing they could do for her beyond sending her home to continue her medication regimen. They said insufficient blood flow to her LAD (left anterior descending) artery – a coronary artery supplying blood to more than half of the heart muscle – ruled out the two most common treatment options: placement of stents to prop open the artery or surgery to allow blood to bypass the diseased area.

Vaux's daughter Joanne Abeling, Director, Clinical Excellence at Edward Hospital in Naperville, was in town for the wedding and stayed throughout her mother's medical emergency. When she heard the doctors' recommendation, she decided to arrange transportation for her mother to Edward Heart Hospital, which she knew had the equipment and expertise for complex high-risk interventional procedures. These types of interventions are appropriate for some patients whose severe heart damage or other conditions make stenting problematic.

When Mark Goodwin, M.D., Medical Director, Cardiology, Edward Heart Hospital and an interventional cardiologist with Midwest Heart-Advocate Medical Group, learned of Vaux's situation, he was ready to use a state-of-the art piece of equipment to make stenting possible.  Impella, a device which can be inserted through a small hole in the leg, helps the heart pump blood during a procedure.

When a patient's condition is too severe for even the Impella approach, the cardiac team at Edward Heart Hospital is prepared to employ another level of care called ECMO (extracorporeal membrane oxygenation), which involves using a bypass machine to take over for the heart and lungs during stenting.

But it turned out neither Impella nor ECMO was needed in Vaux's case. When Dr. Goodwin performed a cardiac catheterization at Edward, he determined that she did have sufficient blood flow to the LAD to make surgery feasible.

Bryan Foy, M.D., System Medical Director, Cardiac Surgery, Edward-Elmhurst Health and a cardiothoracic surgeon with Cardiac Surgery Associates, was also involved in planning Vaux's care. He agreed that she was a candidate for surgery and performed a triple bypass on March 23.

"Without this intervention, Mrs. Vaux had only a 50 percent chance of surviving a year,” says Dr. Goodwin. “Now her prognosis is good.”

Since her discharge from Edward, Vaux is staying with her daughter in Naperville and shining in her cardiac rehab sessions. "I'm told I'm doing better," she says.

“It’s important to have the right equipment for diagnosis and treatment – from X-ray and laser to the more recent developments, such as Impella,” says Dr. Goodwin. “But it's also key to have an experienced, specially trained team to determine the best option for each individual.

"Many high-risk patients with coronary artery disease or chronic total occlusion are not getting the procedures they need. We're seeing referrals for complex procedures from cardiologists in a 10-state area because they're recognizing this need. It's gratifying to think we can often offer something when a patient has been told there's nothing that can be done."

Learn more about cardiac care at Edward-Elmhurst Health.

Find out if you’re at risk for heart disease.

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