Heart ‘Time-Sharing’ Tactic Succeeds

Doctors at a Mission Viejo hospital Thursday used a new surgical procedure--never before tried in Orange County--to lower the risk for a 74-year-old patient undergoing heart bypass surgery for a second time.

“The patient is doing just fine,” said a very pleased Dr. Donald E. Rediker, who performed the new technique at Mission Hospital Regional Medical Center. “I think we’re going to see this procedure used more and more in high-risk cases.”

The procedure--called coronary venous retroperfusion--essentially involved placing a small catheter into a heart vein. It pumped oxygenated blood backward through the vein to keep the heart functioning while bypass surgery took place.

Albert Pape of Old Rancho Santa Margarita, who sings in a local barbershop quartet, had suffered chest pains in recent weeks, primarily because of complications from previous bypass surgery.

A new bypass was needed. But it was risky, Rediker said, partly because of Pape’s age and the condition of his arteries.

The new technique was needed to keep Pape’s heart strong enough to sustain another operation.

“We explained to him what we wanted to do, and how it had not been done here before; he was quite willing to try it,” Rediker said.

The doctor added: “Mr. Pape was smiling and conscious” while the equipment was being inserted before the surgery. “It was really not complicated.”

Rediker said the doctors conducted tests to prove that the equipment was keeping Pape’s heart going during the surgery.

While there is no way to prove that Pape would not have survived the surgery without the technique, Rediker said: “It is certainly quite clear that the risks would have been much much greater.”

In layman’s terms, the new equipment makes the veins serve as arteries while the arteries are under repair. While blood nobmally leaves the heart through the veins, with this procedure the veins spend part of the time taking blood back to the heart.

“We call it time-sharing,” quipped David Pound, a spokesman for Retroperfusion Systems Inc. of Costa Mesa, which manufactures the equipment used in the procedure.

“It doesn’t correct the problem, but it gives the doctors more time to do their job. One doctor called it a lifeboat for the heart.”

Pound said the greatest value for the procedure might be in cases where someone suffers a heart attack and is rushed to the hospital.

“The situation might be so critical,” he said, “that a doctor has only a couple of hours’ time to perform surgery before the patient would die. With this equipment, the surgeon might buy up to eight to 10 hours.”

With more than a million heart attacks in this country each year, Pound predicted that new techniques such as this one could save thousands of lives.

Rediker conducted the catheter procedure with aid from Dr. Gregory S. Thomas, Pape’s cardiologist. The actual bypass surgery was performed by Dr. William N. Thibault and Dr. Robert A. Steedman.

The procedure was developed by Dr. Eliot Corday and associates at Cedars-Sinai Medical Center in Los Angeles. The Food and Drug Administration has approved the procedure at a dozen centers around the country, Pound said.

It was recently approved for Mission Hospital Regional Medical Center for a two-year trial.

Pound was an observer during Pape’s surgery Thursday.

“We had been there for several weeks getting ready, training the nurses and the staff in what to do,” Pound said. “It really was kind of exciting for everyone.”