SALT LAKE CITY – With two tiny incisions and the click of a computer mouse, cardiologists at Intermountain Medical Center’s Heart Institute completed a highly-specialized and innovative approach that made medical history when they combined two technologies into one life-changing procedure for an Idaho man.
At the end of the landmark eight-hour procedure, the Intermountain Medical Center Heart Institute team had not only saved 69-year-old Stephen Summerill’s life, but they did it in a way that had never been done before in the United States.
The heart team combined two new advanced technologies, using a breakthrough computerized magnetic navigation system to three-dimensionally map Summerill's heart to precisely locate the source of his heart rhythm disorder and fix it through the use of a magnetically-guided catheter. At the same time they implanted a miniature, state-of-the-art heart pump to keep Summerill’s weak heart pumping enough blood to keep him alive through the procedure.
The procedure was performed in a catheter lab on Oct. 28 at Intermountain Medical Center by heart rhythm specialist Peter Weiss, MD, and interventional cardiologist James R. Revenaugh, MD, both from the Intermountain Medical Center Heart Institute.
Intermountain Medical Center is the flagship facility for the nationally-renown Intermountain Healthcare system.
“This is a great example of how we were able to utilize different technologies and skill sets to bring top level care to a high-risk patient and ultimately saving his life,” says Dr. Weiss.
Summerill was considered high-risk because his heart function was extremely low, the result of damage caused by nearly 25 years of heart disease. The lower portion of the Pocatello man's heart was so badly damaged, Drs. Weiss and Revenaugh knew he would not survive the procedure to map and fix the rhythm disorder without the aid of the heart pump.
“This was clearly a situation that required a creative approach,” says Dr. Revenaugh.
So they combined the use of the tiny heart pump, known as a TandemHeart peripheral ventricular assist device or PVAD, with the Stereotaxis Magnetic Navigation System to perform the high-risk ventricular catheter ablation – something never before done in the United States.
The two systems had not previously been used together in the United States, partly because of concerns that the electromagnetic field created by the Stereotaxis system would interfere with the TandemHeart's function. (The procedure has been performed a handful of times in Europe without complications.)
The PVAD heart pump was deemed necessary because it pumps up to five liters of blood per minute – about as much as a healthy human heart. Other pumps would not push out enough blood to keep Summerill’s blood pressure at a sustainable level during the procedure.
“Our fears were confirmed when we first administered anesthesia and his blood pressure dropped severely,” recalls Dr. Revenaugh. “If we hadn’t had the TandemHeart pump available, we would have had to abort the procedure and start looking for other options, — and we didn't have a lot of those.”
Using these two technologies resulted in two positive outcomes for Summerill:
- First, by using the TandemHeart PVAD, he was able to sustain a high enough blood pressure to survive the procedure.
- Second, the use of Stereotaxis system allowed for highly detailed three-dimensional mapping and ablation of his arrhythmias with minimal radiation exposure for Summerhill and the medical staff.
The Stereotaxis Magnetic Navigation System uses a soft catheter – much like a spaghetti noodle – containing four magnetic heads. Two large magnetic pods are positioned on either side of the body, creating a strong magnetic field. After entering that same femoral vein to enter the heart, Dr. Weiss uses a computer mouse and the electromagnetic navigation system to create a three-dimensional image of the heart, testing for areas of electrical activity, and cauterizing the damaged heart muscle responsible for the tachycardia.
It took almost eight hours to complete, but the procedure was successful in eliminating the arrhythmias.
Summerill is back at home in Idaho and feeling grateful for the confidence and ingenuity of the team at the Intermountain Medical Center Heart Institute.
“I am very blessed that it all went so well,” he says. “Anyone faced with such a procedure should go to the Heart Institute and feel confident that they are getting the very best care.”