A team with heart

By Tony Waggoner, Staff Writer

April 07, 2008 04:45 pm

— Dr. David Vanhooser, a cardiac, endovascular and thoracic surgeon at Integris Bass Baptist Hospital, and his team have been treating patients in Enid since 2001.
Vanhooser said since 2001 he believes he has performed around 800 bypass surgeries at Bass.
“That averages about 100-150 a year, of just the open heart, what we call ‘pump cases, using the heart-lung machine’” he said.
He said they do about 200-250 cases a year, including lung surgeries, aneurysms and radiology cases.
With that many cases a year, it wouldn’t be hard to believe that Vanhooser is actually a machine himself.
Vanhooser talked about two cases he had done recently. Both were done within a few days of each other.
One of the cases involved a man who was to have a valve replacement — which is open heart — and three bypasses, because of coronary blockages. The man was 80 years old.
“When we got in to do his bypasses, his aorta was very, calcified,” he said. “What we had to do was replace the beginning part of his aorta with a pig valve, which is not just the valve but the aorta also. We had to take his coronary arteries off, and sew them back into the sides of this new pig valve, and do the bypasses and sew it all back together.”
Vanhooser said the whole procedure took about five hours. He said the operation was a huge one for the man, but he was doing fine. He said the reason they were able to do a procedure like this is because of the access to a variety of different valves, pig, metal, cow or root replacement, sitting on the shelf in every size for any patient.
“We have a selection of whatever the patient needs,” he said. “We’re not limited by the equipment.”
Vanhooser’s newest procedure has involved atrial fibrillation, which causes deterioration of the heart’s function, making the patient more likely to have a stroke or blood clots.
“We’ve done nine of them now in the last two months, which is pretty good.” he said.
Vanhooser sees patients from all over the northern Oklahoma area.
“I’d say 25 to 30 percent of the patients come specifically from Enid,” he said. “The rest come from all over northern Oklahoma.”
Vanhooser has even seen patients from Caldwell, Kan., Woodward, Ponca City and Cherokee. Integris Bass Baptist does not compete with Oklahoma City, but Vanhooser said he wishes they had a helicopter to increase the amount of patients he could help.
He and his team are already looking toward a new procedure. He said they are working with Oklahoma City a little bit right now with Jim Long, a surgeon at Integris Baptist Medical Center, on mechanical assist devices like the artificial heart and devices for heart failure.
“We are working with him to get a different type of heart assist device for here in Enid,” Vanhooser said. “I’m currently talking with Dr. Long about which device to buy.”
Vanhooser said the new device would be for patients with conditions like low blood pressure or large myocardial infarctions who need some sort of mechanical assisting device until they recover from their affliction.
The hospital already has a similar device called the abiomed, which is basically an external artificial heart Vanhooser says the hospital only uses about once a year. He said the hospital should have the new device within the next 90 to 100 days.
“We’re going to get a new device, of some sort, with which we can work in cooperation with Oklahoma City,” he said. “Say we have a patient that needs it. We put them on this (new) machine, support them, and then transfer them down to Dr. Long in Oklahoma City for either a permanent device, a heart transplant or whatever they need. That’s kind of coming, but we’re not there yet.”
Vanhooser said he likes the abiomed, and it works well, in his professional estimation, but there some newer ones on the market that are just being released he would like to get access to.
The one he is particularly interested in is called an impella. The impella is a minimally invasive, percutaneous ventricular assist device, like a little catheter with a motor in it, that slides inside the patient. It then sucks the blood from one end and blows it out the other, Vanhooser described.
“It’s kind of an artificial heart from the inside,” he said. “It’s probably the latest, greatest thing that’s come out. I’m hoping that we will have this by the end of this year.”
Vanhooser said the impella will probably allow doctors to save patients that they could not normally save from heart attacks.
“If you have a heart attack the problem in getting you over that heart attack is the first two or three days, when your blood pressure’s low, your heart is not pumping enough to profuse your brain and your kidneys, so you need some sort of mechanical help.”
The impella can be placed inside a patient at the onset of the heart attack to get their blood pressure up, let their heart rest and support the heart through the first few days.
Vanhooser said his primary focus right now is on the new atrial fibrillation procedure.
Sources say the hospital has something big on the horizon for the cardiovascular department in Enid. Vanhooser is hoping sometime in the near future they will be able to bring in more cardiologists to the area, but he is quite happy with the progress that the hospital has made.
“In 2000, they weren’t doing heart surgery,” he said. “We had a functioning ICU (Intensive Care Unit), but it was basically a primary care hospital with pretty good general surgery. Now, we’re doing major valve replacements and aneurysms from the inside. It’s a huge amount of progress in five years for the hospital and community both.”

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