Donald Erion, an AngioVac patient, with his wife, Carol Erion
Donald Erion deals with many complexities in his job as a manufacturing engineer for the Boeing Company.
“It’s technically challenging, but it’s a lot of fun,” he said. “I’m one of many on the team, and we build some great products.”
Donald, 59, found himself immersed in another complex process recently: determining his treatment for a large, potentially deadly blood clot in the right atrium of his heart. On Dec. 30, he became the first patient at St. Anthony’s to undergo the minimally invasive AngioVac procedure, avoiding open-heart surgery.
St. Anthony’s is among only a few hospitals in the region to offer the AngioVac technology, which uses an extra-large tube to remove blood clots from the heart and uses a bypass circuit to reinfuse filtered blood back into the body. It has been used since 2013 for about 1,000 procedures nationwide.
He returned to his home in Lincoln County four days later and returned to work on Jan. 12.
“Right now, I’m feeling almost back to normal,” he said. “It was just a matter of getting my energy back up; it’s nothing compared to what I probably would have experienced with the open-heart surgery.”
“We’re very happy with the outcome, and we’ve had excellent care from everyone at the medical center,” added Carol, Donald’s wife of 39 years.
For Donald and Carol, the events leading to the procedure presented an emotional rollercoaster ride. Donald suffers from atrial fibrillation; he is a patient of Gregory Botteron, M.D., and Charles Carey, M.D., of St. Anthony’s Heart Specialty Associates. Last summer, he suffered a small stroke and further tests determined he had ventricular tachycardia, or a rapid heartbeat that arises from improper electrical activity in the heart. In October, Dr. Carey ordered a Trans-Esophageal Echocardiogram (TEE), which revealed the inch-and-a-half-long clot fastened to the lead of his pacemaker within the heart chamber. Dr. Carey prescribed a course of blood thinners, but they failed to dissolve the clot. In fact, the clot increased in size. Doctors worried the clot had caused the first stroke and could cause others.
“On Dec. 15, he admitted me to St. Anthony’s,” Donald recalled. “Then, it became a larger team of doctors who reached out to a greater medical community. They did an excellent job of keeping us in the loop.”
Options included a median sternotomy, or open-heart surgery, to remove the clot; or the AngioVac procedure. St. Anthony’s did not have the device.
“What made this particular case unique was the size of the mass we had to remove,” noted heart surgeon Seiichi Noda, M.D., of St. Anthony’s Heart and Vascular Institute. “Some smaller clots we can get out with pre-existing devices, but not in this case. Donald had the clot because he had a pacemaker, and any foreign body can be a possible source of a clot.”
Interventional radiologist Kiran Chunduri, M.D., was certain he could perform the procedure safely, even though it had never been done at St. Anthony’s.
“I talked with Dr. Noda, and we discussed it with the patient,” recalled Dr. Chunduri of South County Radiology. “It’s a testament to this hospital’s dedication to patient care that the administration approved the purchase of this expensive device within three days. It helped save the patient a major surgery and a long recovery. And it’s allowed us to further our mission of keeping the most challenging and complicated cases here and offering our patients the most advanced procedures.”
Knowing the teamwork involved, Donald consented to the AngioVac procedure.
“Because we were part of the process from the beginning, because we saw that the medical team came to a unanimous decision verified with outside doctors, and because we knew the procedure would be done with the full surgical team ready to step in if anything were to go in the wrong direction, all those aspects helped us to have confidence that this was the right decision,” he said.
Dr. Chunduri performed the 3½-hour procedure under general anesthesia. He was assisted by Dr. Noda, who was ready to perform open-heart surgery in the event of complications; anesthesiologists Asad Qayum, M.D., and Q. Dang, M.D.; and perfusionist Floyd Daniel, BS, CCP.
“The most common use of the AngioVac device is for people who have blood clots in their inferior vena cava, which is a large vein that carries blood from the lower extremities back into the heart,” Dr. Noda said. “It’s not an everyday procedure. But I think for that unique patient with a unique problem, this is a very good option that a lot of other hospitals can’t possibly offer.”
Donald and Carol look forward to doting on their nine grandchildren, the youngest of whom was born on New Year’s Day.
“Having that clot removed is significant,” he said. “Our grandkids are a lot of fun, a lot of energy. We’re anticipating having more opportunities to spend time with them.”