December 12, 2007

Mercy Marks First for Region with Breakthrough Procedure to Treat Abnormal Heart Rhythm

Doctors at Mercy Medical Center—Sioux City have performed a revolutionary new procedure that corrects atrial fibrillation (AF), a common form of heart rhythm abnormality and a major cause of stroke. The new minimally invasive microwave ablation Maze procedure is a considerably more patient-friendly alternative to traditional open-chest “Cox-Maze” procedures and offers new hope to many AF patients.

On Nov. 27, Robert Buss, 77, of Laurel, Neb. became the first Siouxland area patient to undergo a closed-chest Maze procedure. Mercy Cardiothoracic Surgeon Dr. Keith Allen performed the advanced procedure, and is now one of only 70 U.S. surgeons specially trained for the sophisticated practice.

“The region’s first procedure of this type went very smoothly,” Allen said. “We are pleased to offer patients a minimally invasive Maze option that provides the same long-term benefits for the treatment of AF, but with far less surgical stress and a shorter recovery time.”

“This treatment option has the potential to help many of the people who suffer from atrial fibrillation, returning them to normal heart rhythm and significantly reducing their risk of stroke,” Allen added. “Used successfully on patients who are good candidates for the procedure, it is a good alternative to major cardiac surgery or a lifetime of medication.”

Even though he has since picked up a winter cold, Buss says he is feeling better after having the procedure.

AF, or “AFib,” is an irregular heart rhythm that compromises the heart’s ability to pump blood. Abnormal electrical signals begin at the top of the heart and travel down the heart muscle, causing the atria, or upper chambers of the heart, to contract erratically. As a result, blood pools in the atria and forms clots that can travel to the brain and cause stroke.

Traditionally, the surgical treatment for AF involved a major operation. Doctors cut the breastbone or sternum and usually put the patient on a heart-lung machine so his or her heart could be stopped.

As a result, the more invasive surgical procedure was generally only performed on patients in association with other planned cardiac surgery, such as valve repair and coronary artery revascularization.

Now, patients can realize the benefits of the Cox-Maze operation in a stand-alone procedure, without undergoing a major, open-heart operation.

The more contemporary minimally invasive microwave ablation procedure involves the use of thoracoscopy, whereby a tiny video camera is inserted into the sides of the chest and instruments specially designed for the procedure are inserted via small ports or keyhole incisions.

Guided by their tiny camera inside the chest cavity, specially trained surgeons like Allen loop a catheter, a thin tube, around the heart. When the catheter is activated with microwave energy, it creates a lesion around the atrium that will scar and block the electrical impulses causing the irregular heartbeat.

While cardiothoracic surgeons at Mercy have been performing the more conventional Cox-Maze surgery for some time, last week’s medical advance marked the first time in the region that the microwave ablation procedure was undertaken in a minimally invasive manner.

“It is a good example of how we remain a progressive, but safe, state-of-the-art cardiothoracic surgery program,” Allen added. “We are committed to offering our patients the latest innovations in the treatment of heart disease.”

Approximately 2.4 million people in the U.S. suffer from AF and more than 300,000 new cases are diagnosed each year, according to the American Heart Association. The condition carries serious consequences. AF increases the risk of stroke by five to seven times, and is a major contributor to the development of congestive heart failure.

AF is often treated with anticoagulant drugs, which do not address the abnormal heart rate but instead are used to prevent the formation of blood clots. Other treatments, including catheter-based procedures and older forms of surgery, are available to correct the abnormal heart rhythm, but these treatment options are much more infrequently used because they are highly invasive, difficult to perform, and appear to be less effective.

According to Allen, microwave ablation procedures eliminate AF in more than 85% of selected patients who undergo them. “With the minimally invasive Maze procedure, we can offer our patients a better option,” he added.

Mercy’s expertise in advanced cardiac procedures has helped maintain a regional and national reputation for heart-related care. The hospital is ranked No. 1 in Iowa for its quality of care and clinical outcomes for cardiac care, cardiology services, heart surgery and cardiac interventional procedures according to a study released in October by HealthGrades, the nation’s leading independent healthcare ratings company.