Dr. John Breaux, a cardiothoracic vascular surgeon at Lakeview Regional Medical Center, a campus of Tulane Medical Center, recently performed four complex open heart surgical procedures during the same operation, becoming the first surgeon in the United States to execute this type of surgery involving a series of procedures that each depended on the other.
The incredibly complex operation likely saved the life of Larry Edmondson, a 64-year-old Pearl River resident who was suffering from severe end-stage heart disease and was at risk of sudden death from aneurysm.
Edmondson was unable to walk across a room without immediate fatigue and serious chest pain, he said. He was diagnosed with advanced end-stage heart failure and a multitude of issues that could not be managed with conventional heart therapies or symptom management strategies.
In the past five years, many new technologies have greatly helped in the care of patients with a single heart problem. Due to Edmondson’s extensive medical problems, however, the option of performing the procedures in stages did not exist. The only option was for Breaux to perform four surgical procedures within a single operation, which had never been done with these specific interventions.
“When I perform complex open heart surgery, I go into the operating room with a well-thought-out plan and a backup plan, both of which are standard routines,” said Breaux, who practices with Lakeview Regional Physician Group. “In this case, I had to develop a very complicated plan which had never been attempted before, but with our team of experts at Lakeview Regional, I knew we could make it happen.”
Advanced technologies allow for a very tiny heart pump to be used to improve severe heart disease, but the pump can only be placed in the heart muscle in the operating room with major intervention. The device is intended to pass through the blood vessel of the arm through the patient’s healthy ascending aorta, then through the patient’s healthy aortic valve and into the failing left ventricle.
In Edmondson’s case, the vessels, aorta and valves were failing and needed repair before the heart pump could be put in place. Breaux and his team performed a two-vessel coronary artery bypass grafting, followed by a Maze atrial fibrillation ablation procedure, an aortic valve replacement, an ascending aorta replacement, and finally the placement of the heart pump.
“This is an extremely unique case and the first time a complex surgery like this has been done in the United States,” said Daniel H. Raess, vice president and senior medical director for Abiomed, makers of the heart pump used in Edmondson. “Dr. Breaux’s foresight to devise this plan and the expertise needed to succeed with such an operation was phenomenal.”
Edmondson’s heart recovered and rapidly regained strength. The heart pump was removed five days following the initial surgery, and Edmondson was discharged in good condition four days later.