Health Aware: Edward doctor at forefront of treating chronic total occlusions

Edward site of prestigious CTO training

Cardiologists across the country converged on Edward Heart Hospital on April 17 and 18 to learn new techniques to treat Chronic Total Occlusion (CTO) of the coronary arteries.

The Boston Scientific Coronary CTO Regional Training Course was led by Dr. Mark Goodwin, medical director of Edward Heart Hospital’s Cardiac Catheterization Lab and interventional cardiologist with Midwest Heart-Advocate Medical Group, and Dr. Tony DeMartini, chief operator and CTO physician for Boston Scientific. Both are nationally recognized for their expertise in CTO procedures. Goodwin has been treating CTO patients since 2008. Edward performs 120 CTO procedures each year.

During the two days, Drs. Goodwin and DeMartini demonstrated and explained the techniques live during procedures that were shown to about 30 physicians in a conference room in the Edward Heart Hospital via a video feed and to physicians around the world via the Internet. The physicians in the conference room were able to ask questions of Drs. Goodwin and DeMartini during the procedures.

Boston Scientific holds the CTO course at a limited number of facilities across the country to train physicians on how to successfully and safely conduct the CTO procedures. Physicians must complete online training with testing and be proctored for up to six cases in their home hospitals before they can do the procedure on their own.

— Edward Hospital

Living with a completely blocked coronary artery is possible, but it isn’t easy.

Dependent on medication to get him through the day, Russell Vestuto, 69, of Plainfield couldn’t carry a bag of groceries into the house without pain in his chest and back.

The physical requirements of his job in a retail garden center caused more pain than he could bear, so he quit.

“It was so bad, I didn’t want to live with it,” Vestuto said. “Either you fix it, or I croak.”

About 12 years earlier, Vestuto had bypass surgery. He said the artery was clogged then, but doctors could not remove the blockage.

Chronic total occlusions (CTOs) remain a clinical dilemma and a challenge for clinicians treating patients with cardiovascular disease. There are hundreds of thousands of people with CTOs, which in many cases, were untreatable. Some CTOs are treated with bypass surgery, but 60 percent of patients with CTOs are treated only with prescription drugs.

Now, new techniques and strategies developed by an elite group of doctors, including an Edward Hospital cardiologist, have made it possible to unclog those arteries.

In Vestuto’s case, the bypass operation alleviated some discomfort. However, his chest pain had been steadily increasing the previous three years. He was downing 100 nitroglycerin pills each month to help widen his blood vessels and ease the pain.

Then, a friend recommended he get an opinion from an Edward cardiologist.

Vestuto met with Dr. Mark Goodwin, medical director of Edward Heart Hospital’s Cardiac Catheterization Lab and interventional cardiologist with Midwest Heart-Advocate Medical Group. Goodwin said he could clear Vestuto’s artery.

The best strategies and new techniques for treating CTOs are being developed by a team of 20 leading CTO operators around the world, including Goodwin. These new techniques have allowed doctors to reopen the clogged arteries 90 percent of the time.

“This is a great new advance to give patients options and improve their quality of life,” Goodwin said. “Mr. Vestuto had no options. Afterward, he felt like he got his life back.”

Edward is at the top end of experience treating CTOs and is one of the top hospitals in the country in terms of its success rate. If a blockage is too hard to push through, doctors there have developed new techniques to go around or through the blockage.

Goodwin was able to push through the blockage and insert a stent to keep the formerly-blocked artery open.

For Vestuto, the CTO operation was life-changing.

“The effect from it was immediate,” Vestuto said. “The man saved my life. The chest pain was totally gone. I’ve gone from 100 (nitro pills) in a month to maybe one in a month. I couldn’t go on like that anymore.”

Vestuto returned to work, resumed his household chores and has a new outlook.

“Believe me, the difference was night and day. One minute you’re in bad shape. The next, it’s over and done with,” Vestuto said. “The next day, there was no more pain. It’s unbelievable.”

For more information, visit or call 1-877-45-HEART to make an appointment.

Health Aware is a weekly column courtesy of Edward Hospital.