Minimally Invasive Procedure Replaces Open Heart Surgery:


In April of this year, Engracia Bimbella, 57, of Santa Barbara arrived at Santa Barbara Cottage Cottage Hospital hours after experiencing chest pains.

Dr. Kevin Young, identified her as suffering from a major heart attack as a result of a blocked artery, and Dr. Thomas Watson then performed an urgent angioplasty to open the blockage. In the following 24 hours, Engracia's condition worsened and she was diagnosed with a "ventricular septal rupture," a rare and often fatal complication after a heart attack.

This tear creates a passageway between the lower chambers of her heart and if not treated is almost universally fatal. However, the most common method to repair the defect is to do open heart surgery, which in itself is extremely high risk and complicated in the days after a heart attack.

Dr. Joseph Aragon, a member of the hospital medical staff and a physician at Sansum Clinic, who specializes in Interventional Cardiology and Structural Heart Disease, was consulted to repair Engracia's heart using an invasive but non-surgical technique. Instead of opening the chest in the operating room, the procedure can be done in the cardiac catheterization lab using a catheter.

This method of repair for a septal defect is a safe and effective treatment that often can be completed in less than two hours. A device called a septal occluder, which resembles a tiny umbrella, is used to rapidly reverse the effects of the tear and stabilize the patient.

Using catheters inserted in the groin and the neck, Dr. Aragon guided a tiny device called the CardioSEAL into the patient's heart. The CardioSEAL is made with a metal frame and fabric and resembles an umbrella. While closed, the device can be guided in to position, and when it's opened it patches over holes and tears in the heart.

X-ray guidance and cardiac ultrasound are used to ensure that the patch is put into place correctly. Over time, the heart's normal tissue develops over the device, which becomes part of the wall of the heart, permanently closing the defect.

The CardioSEAL device has a long track record of success in treating this type of cardiac defect. In many cases it can allow a patient to fully recover and go back to a normal life or be used as a bridge to surgery in the sickest patients allowing the torn muscle time to heal so the risks of surgical repair are more acceptable, Dr. Aragon explained.

This is the first time this procedure was used in the tri-county area to repair a ventricular septal defect resulting from a heart attack, according to Dr. Aragon. Prior to his arrival at Cottage, patients would only have a surigcal option to treat this defect.

Engracia has recovered well and is in rehabilitation to strengthen her heart.