Suffering from shortness of breath, fatigue and extreme cold, Todd Dunlap, 62, arrived at Ronald Reagan UCLA Medical Center's emergency room on Aug. 8. When a CT scan revealed a 24-inch clot stretching from his legs into his heart, doctors feared the mass could break loose and lodge in his lungs, blocking oxygen and killing him instantly.
Dr. John Moriarty gave his patient a choice. Dunlap could have open-heart surgery or undergo a new minimally invasive procedure using a device called AngioVac to vacuum the massive clot out of his heart. The catch? The procedure had never been successfully performed in California.
A new grandfather, Dunlap didn't hesitate to choose the second option and underwent the procedure on Aug. 14. A week later, he was home, full of energy and eager to play on the floor with his 9-month-old grandson.
Here's how it worked: A team of UCLA interventional radiologists and cardiovascular surgeons slid a tiny camera down Dunlap's esophagus to visually monitor his heart. Next, they guided a coiled hose through his neck artery and plugged one end into his heart, against the clot. They threaded the other end through a vein at the groin and hooked the hose up to a powerful heart-bypass device in the operating room to create suction.
"Once in place, the AngioVac quickly sucked the deadly clot out of Mr. Dunlap's heart and filtered out the solid tissue," said Moriarty, a UCLA interventional radiologist with expertise in clot removal and cardiovascular imaging. "The system then restored the cleansed blood through a blood vessel near the groin, eliminating the need for a blood transfusion."
The procedure lasted three hours. Doctors observed Dunlap for three days in intensive care before transferring him to the hospital's cardiac ward and then discharging him four days later.
Open-heart surgery takes twice as long to perform and often requires the surgeon to divide the breastbone lengthwise down the middle and spread the halves apart to access the heart. After the heart is repaired, surgeons use wires to hold the breastbone and ribs in place as they heal. The procedure can necessitate extended rehabilitation before the patient makes a full recovery.