High tech equipment helps in heart surgeries

May 3, 2021

Providence Heart & Vascular Team

This story was originally published in the Winter 2021 edition of Providence Health Matters.

[4 MIN READ]

At Providence Saint Joseph Medical Center, we strive to provide compassionate care coupled with state-of-the-art technology to patients with serious cardiac or lung issues. One of the many resources we now have available is extracorporeal membrane oxygenation, or ECMO.

What is ECMO?

An ECMO machine is similar to a heart-lung machine used in an operating room during heart surgery. But there’s an important difference. “ECMO uses a mini version of the heart-lung machine,” says Bob J. Gottner, MD, director of cardiovascular surgery. “With it, we can help the patient at the bedside.”

ECMO provides life support to patients whose heart or lungs are not working properly. Blood is pumped outside the body to the machine, which oxygenates it, filters out the CO2 and returns it to the body.

ECMO provides life support to patients whose heart or lungs are not working properly. Blood is pumped outside the body to the machine, which oxygenates it, filters out the CO2 and returns it to the body. The heart, lungs or both are bypassed, so they can rest and heal while the machine does the work.

ECMO is typically used for patients who have had open-heart surgery or significant damage after a heart attack. “We’ve used ECMO after surgery when we’ve had difficulty getting patients off the heart-lung machine in the operating room,” says Dr. Gottner.

The machine is also used for patients with serious lung damage—for example, from pneumonia or COVID-19—who cannot breathe on their own and are often on ventilators.

When we use ECMO for patients with COVID-19, we are able to save many of these patients that once had a 100 percent probability of dying.

“We started utilizing ECMO in 2015 during the H1N1 pandemic. We were seeing many young patients and patients with minimal co-morbidities, conditions like high blood pressure or diabetes, dying as conventional ICU care was just not able to sustain these patients during the acute phase of their illness. Much like the current pandemic, we are in now,” says Wayneinder Anand, MD, ICU co-medical director. “When we use ECMO for patients with COVID-19, we are able to save many of these patients that once had a 100 percent probability of dying.”

Currently, Providence Saint Joseph is one of the few facilities in the country with ECMO equipment and highly trained staff and physicians.

Currently, Providence Saint Joseph is one of the few facilities in the country with ECMO equipment and highly trained staff and physicians. According to an April 2020 article in The Washington Post, only 264 out of more than 6,000 hospitals in the country have ECMO.

Although ECMO treatment can save lives, not all patients are good candidates, as survival rates are only around 50%. “ECMO is for patients who have a limited chance of survival without it, yet also a high chance of survival with it,” says Dr. Gottner. “Our goal is to get patients back to a normal life.”

Lives that would have been lost have been saved by ECMO and our cardiology team. “Patients who have had ECMO have come back to the hospital to thank us,” says Dr. Gottner. “So, clearly, ECMO at Providence Saint Joseph has had a lifesaving impact.”

Another breakthrough technology: TAVR

When the aortic valve in your heart cannot function properly due to a buildup of calcium, your risk of heart failure increases dramatically. This condition, severe aortic stenosis, prevents blood from flowing easily through your body, forcing your heart to work harder. In the past, open heart surgery was the only way to replace the aortic valve. But at Providence Saint Joseph Medical Center, we offer a minimally invasive procedure for aortic valve replacement called transcatheter aortic valve replacement (TAVR).

Unlike open-heart surgery, TAVR does not require surgeons to open the chest.

Unlike open-heart surgery, TAVR does not require surgeons to open the chest. Through a small incision in the thigh or groin, a thin, narrow catheter guides the new aortic valve to the heart, where it pushes away the old valve and takes over its job. “It’s a pretty nifty technology,” says Bob J. Gottner, MD, director of cardiovascular surgery at Providence Saint Joseph. Although TAVR, like all surgery, has its risks, both hospital stay and recovery time are dramatically faster. ”Patients often go home the next day,” says Dr. Gottner.

The TAVR procedure is appropriate for most patients, whether low- or high-risk. Dr. Gottner explains that it’s best for patients over 60, or those under 60 with a limited life expectancy. “The valves do wear out, and multiple procedures over time is not a good idea,” he says. At Providence Saint Joseph, we have a strong cardiac surgery team, including Dr. Gottner, with extensive experience performing TAVR procedures. “We’re bringing this technology to the community so that they don’t have to travel elsewhere for it and can be closer to home,” he says.

For more information, call 844-987-0488 or learn more here.

Learn more about TAVR and if you are a candidate.

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Schedule your appointment with your cardiologist today and to find out if TAVR is right for you. You can find a Providence cardiologist using our provider directory. Or, you can search for a primary care doctor in your area.