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Cardiac teams join forces in Edward’s Hybrid OR

When a sore pinky toe led Aurora resident Terry Wallace, 64, to visit his doctor in July, he never imagined he was sitting on a problem that could cost him his leg.

He was an avid golfer, worked out five times a week, and he hadn’t been having any profound symptoms.

Dr. William Stephan, a cardiologist with Edward Heart Hospital and Midwest Heart-Advocate Medical Group, examined Wallace and ordered imaging tests of his leg. The diagnosis: a leg aneurysm, which is a weakened, bulging area in a blood vessel wall. He learned his aneurysm was severe enough to require surgery or at least angioplasty, a less invasive, catheter-based intervention that would help keep the aneurysm from rupturing.

And he might need both surgery and angioplasty.

Dr. Mark Goodwin, medical director of Edward Heart Hospital’s Cardiac Catheterization Lab and interventional cardiologist with Midwest Heart-Advocate Medical Group, did an angiogram of Wallace’s leg. The test uses X-rays to find blockages in the arteries supplying blood to the leg.

“I didn’t do an angioplasty at this point because I was concerned about how much clot was in the leg,” Goodwin said.

In an angioplasty, a balloon-tipped catheter is threaded through a tiny incision to the site of the aneurysm. There, a balloon is inflated to flatten the aneurysm, allowing a stent to prop open the vessel.

“The blockage was causing insufficient blood flow to the leg,” says Marissa Marshall, clinical leader of cardiovascular surgery at Edward. “Surgical repair of the area would be needed before an angioplasty could happen.”

Because Wallace needed both vascular surgery and catheter-based intervention, he was a good candidate for Edward Heart Hospital’s Hybrid Operating Room, which features the most technologically sophisticated equipment available to ORs and cardiac procedure rooms.

“The advanced imaging system allows the physician to see extremely fine details. And the room can easily hold as many as 20 people, which is important when both a surgical team and an endovascular intervention team are needed,” Goodwin said.

But it’s the logistical advantage of having one room for both the surgery and the intervention that may benefit patients most, according to Marshall.

“It saves time and trauma for the patient when they don’t have to move from one room to another,” she says. “Even when the two teams aren’t in the Hybrid OR at the same time, we can have one of the teams ready to come in when the first team finishes up.”

On Aug. 12, a team of about a dozen health professionals gathered in the Hybrid OR to address Wallace’s aneurysm. Vascular surgeon Dr. James Walsh of Cardiac Surgery Associates performed bypass surgery, creating a detour around the aneurysm. Goodwin then stepped in to do the endovascular repair, which included angioplasty and insertion of a covered stent to seal the aneurysm.

Wallace returned to the Hybrid OR on Aug. 14 for treatment of complications caused by a hematoma.

This time, Walsh’s partner, Dr. Bryan Foy, medical director of cardiac surgery at Edward Heart Hospital and a cardiothoracic surgeon with Cardiac Surgery Associates, led the surgical team, and Goodwin, the cardiac intervention. Together they were able to safeguard blood flow to the leg and help prevent future blood clots.

“Each of these sessions in the Hybrid OR resulted in saving Terry’s leg,” says Marshall.

Edward Heart Hospital is one of only a few area hospitals to feature a Hybrid OR. In addition to treatment for leg aneurysms, the Hybrid OR has been used for aortic valve replacements, abdominal aortic aneurysm repairs, removal of implanted defibrillators and pacemakers and coronary artery bypass surgeries.

Wallace is working diligently on his outpatient physical therapy.

“I’m able to walk around the block, and I’m looking forward to getting back to golf,” he says.

For more information, visit www.edward.org/heart, or call 630-527-2825 or 877-454-3278.

Health Aware is a weekly column submitted by Edward Hospital.

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