Christian Hospital Hybrid Room Procedures Save Lives

Christian Hospital is proud to provide leading-edge heart procedures for its patients. These treatments have continued to expand and refine since the introduction of its “hybrid room.” Equipped with advanced medical imaging technology, it combines the equipment of a cardiac catheterization lab with the features and capabilities of an operating room when more complex surgical treatment is required.

Two such procedures performed in this room are Transcatheter Aortic Valve Replacement (TAVR) and vacuum-operated thrombectomy (AngioVac) procedures. Both are minimally invasive and have treated life-threatening heart problems.

TAVR

TAVR is a treatment option for patients with a condition called aortic stenosis, which is narrowing of one of the valves on the left side of the heart. If severe aortic stenosis is left untreated, it can lead to heart failure. Replacement of the valve can be done by open heart surgery or minimally invasive TAVR.

Initially, TAVR was reserved for only the riskiest of patients who would not be able to undergo surgery, but after a series of trials, they’ve started including lower-risk patients.

TAVR works by inserting a catheter through an artery in a patient’s groin, arm, shoulder or neck. It is then guided through the blood vessels to the heart and into the aortic valve where the new valve is positioned and expanded. Recovery from the procedure is relatively short, with many patients going home the next day. Most patients feel better almost immediately and recover within the next week or two.

For Earl Berry of north St. Louis, the Christian Hospital heart team performed a TAVR in TAVR procedure, which is when a transcatheter valve replacement is done inside of a previously implanted transcatheter valve that is no longer functioning properly. “I went to see Washington University cardiothoracic surgeon, Dr. Ray, and talked to him and Andy about the procedure, and they even showed me a mockup of the valve they were going to use and where it would go.

"I was a little bit concerned because I didn’t know anybody else that had a valve inside of a valve, but each visit back to Dr. Ray’s office reassured me, as he said it was absolutely doable,” says Earl. No wonder this all seemed so new to Earl — he was one of the first patients in the St. Louis area to receive a planned (non-emergent) TAVR in TAVR, and the first to have it done by an alternative access site through the carotid artery in the neck.

Earl also lives with renal failure, which made his case even more complex. Not only did his procedure go well, but he is also now doing well. He is now able to be placed on the kidney transplant list.

“Normally, these artificial valves don’t last long in patients with renal failure. Since Earl is now eligible for a kidney transplant, his valve may last longer,” says Dr. Ray.

AngioVac

AngioVac procedures are different from TAVR in that their goal is to suction things out of the heart, such as clots or vegetations (abnormal growths which contain bacteria), using a circuit system. The AngioVac’s catheter goes through  the groin or neck veins and creates a circuit where blood is sucked out and returned to the patient after being filtered, maintaining circulation. The filter catches the clot or vegetation so that it is removed from the patient. “Recovery is quick and patients go home the same day after a successful procedure,” says Deepak Koul, MD, FACC, interventional cardiologist. 

Julian Thompson of North County is one such example, whose journey began when a routine CAT scan revealed a large clot in his right heart. That’s when he discovered that he was at risk of pulmonary embolism, even though he had no symptoms.

Fortunately, the multidisciplinary heart team at Christian Hospital was able to perform a minimally invasive AngioVac procedure in the hybrid room to remove the clot. His recovery was fast. “I recovered so quickly, I was back to work in no time,” says Julian.

Many hospitals offer these types of procedures, but what makes Christian Hospital special is the collaboration behind the procedures. “The collaboration between our cardiac surgeons and the four different cardiology groups that we have makes the Christian Hospital heart program and team special,” says Andy Pitts, RN, MSN, Heart Valve Program and Protected PCI coordinator. “We have a very collegial atmosphere and all strive to bring medical school, big academic center medicine to a small community hospital.”

The approach to heart care at Christian Hospital includes cardiologists from multiple groups with different specializations and interests. Every part of the process from the preoperative clinic to the procedure to the post-op care is all done by professionals that are trained to take care of patients with heart conditions.