Hybrid technique helps heart patients

MCR Heart Center prolific in Colorado, Nebraska and Wyoming treating CTO with a percutaneous interventional approach.
January 20th, 2016

It was less than a year ago that Phillip Schweitzer was flown to Medical Center of the Rockies in Loveland because of a heart attack.

“He was in a lot of trouble,” said Dr. Anthony Doing, a cardiologist with UCHealth Northern Colorado.  “The right artery was almost closed, and the other two were already blocked.”

Nebraska resident Phillip Schweitzer is back enjoying life after UCHealth cardiologist were able to use a hybrid of techniques combining approaches from different parts of the world to address Schweitzer’s two completely blocked coronary arteries. Photo by Steve Frederick, for UCHealth.
Nebraska resident Phillip Schweitzer is back enjoying life after UCHealth cardiologist were able to use a hybrid of techniques combining approaches from different parts of the world to address Schweitzer’s two completely blocked coronary arteries. Photo by Steve Frederick, for UCHealth.

There are three main coronary arteries that supply blood to the heart muscles, and Schweitzer’s best one was 70 percent narrowed, Doing said. Schweitzer was deemed too high of a risk for bypass surgery.

“Most cases where there are blocked arteries, we’d do bypass surgery,” Doing said. “But the surgery team felt his heart function was too poor, and given the ongoing heart attack his surgical risk would be extremely high.”

But Schweitzer — just six months after his heart attack and without bypass surgery — is feeling like his old self again.

Skilled cardiologists offer alternatives to bypass

Coronary artery chronic total occlusion, or CTO, occurs when a coronary artery becomes completely blocked — which was the case for two of Schweitzer’s arteries. It usually happens over time because plaque builds up in the arteries, Doing said. Smaller arteries then have to work harder to carry that blood, and when a person exerts him or herself, those smaller arteries struggle to meet the demand and therefore, can cause chest pain and discomfort.

Traditionally, CTO could only be treated with either medications or bypass surgery, Doing said.

“Since February 2012, the [Medical Center of the Rockies] CTO program has been the most prolific in Colorado, Nebraska and Wyoming treating CTO with a percutaneous interventional approach,” he said. “The team is dedicated to treating coronary arteries that are chronically occluded and not possible to treat with standard interventional techniques by using a hybrid of techniques combining approaches from different parts of the world.”

MCR’s program is one of only 13 on the Hybrid Registry, which includes hospitals such as Harvard and the Mayo Clinic. And its success with hybrid techniques has earned it coverage in four different medical journals within the past year. MCR’s Dr. Doing and Dr. Philip Dattilo are among only a few cardiologists in Colorado trained to conduct the hybrid approach. They take a team approach towards fixing CTOs and both trained under Dr. William Lombardi, one of the top operators of CTO procedures nationally.

“By using the latest technology and approaches, the CTO team can improve quality of life and relieve chest pain,” Doing said.

Returning to life quicker

“I feel great,” Schweitzer said. “I’ve been able to resume life as it was before with the addition of a few medications, eating right and exercising more.”

At five feet, nine inches and 150 pounds, Schweitzer thought he was relatively healthy. He had an annual physical each year, was working to lower his cholesterol, and took daily walks.

But Doing warns that coronary blockage doesn’t just happen in unhealthy people.

“The idea that this happens because a person did something wrong is not entirely true,” he said. “Heart disease is a problem for all people across the board, and can even happen in young people. Blockage is the natural progression of the disease, and it’s not just present in unhealthy people.”

Schweitzer had occasional chest pains and shortness of breath — common signs of heart disease — when he was shoveling snow the winter before, but he thought it was due to the cold.

Then as spring came, he started to notice he was getting tired more easily, and on May 8, while mowing his lawn, his symptoms returned with force. He was transported by ambulance to Scottsbluff (Neb.) Regional Medical Center, where they administered a clot-busting blood thinner and then flew him to MCR.

Doctors repaired the 70 percent blockage after Schweitzer arrived at the hospitals, and then scheduled CTO procedures to address the other two arteries.

MCR Heart Center cardiologists used CTO hybrid techniques on both blocked arteries. During the non-invasive procedure, a doctor threads a catheter up through the groin or wrist arteries to reach the blocked coronary arteries and restore blood flow.

“The procedure is almost completely pain free,” Schweitzer said. “It’s like having a tooth filled with the benefit of Novocain. In medical terms, it was a 1 or 2 on a pain scale of 1 to 10.”

In most cases, CTO patients have a short recovery times and spend approximately 24 to 48 hours at the hospital.

“The procedure leaves one unmarked,” Schweitzer said. “During the procedure, you are awake, you hear staff and surgeons talking, and they keep you informed on what is happening and when it’s nearing the end.

“Just the thought of open-heart surgery … fortunately for me, my doctors had other options.”