For Dr. Laurent Lewkowiez, treating Raymond MacDonald offered a chance to be the first in Denver, maybe Colorado, to perform a groundbreaking heart procedure. It also, Lewkowiez said, provided the most exciting, rewarding moment of his career. And MacDonald slept through the whole thing.
When MacDonald showed up at the University of Colorado Hospital on Oct. 27, he was unconscious and in trouble. His heart was beating erratically, and the standard treatments tried at another hospital – shocking and medication among them- hadn’t fixed the problem.
That left few options for saving MacDonald’s life.
The options included putting MacDonald on the list for an emergency heart transplant and trying to implant a temporary mechanical device to keep him alive until a transplant heart became available, Lewkowiez said.
But Lewkowiez had one other trick up his surgical-gown sleeve.
That trick was a relatively new procedure called an epicardial ventricular tachycardia ablation. That is doctor-speak for burning off the scar tissue on the surface of MacDonald’s heart.
Most often, such scarring is inside the heart, usually as the result of a heart attack. But to get to MacDonald’s scar tissue, Lewkowiez and Dr. William Sauer had to insert a catheter in the tiny space between the heart’s surface and the protective layer surrounding it.
Lewkowiez had been trained in the procedure about three years earlier at the University of Pennsylvania, but he hadn’t had the opportunity to use his new skills.
After about six hours of surgery, it was clear the procedure worked. MacDonald’s heart was beating normally again.
“We were ecstatic,” Lewkowiez said. “He went from possibly needing an emergency transplant to walking out of the hospital. That’s why you do what you do.”
MacDonald first learned there was a problem with his heart four years ago when he collapsed playing volleyball.
Doctors diagnosed a ventricular arrhythmia – an abnormal rhythm in the bottom chamber of his heart.
That kind of erratic rhythm is the most common cause of sudden cardiac arrest, which kills about 325,000 adults nationwide every year, according to the Cleveland Clinic heart center.
So doctors implanted an electronic defibrillator in MacDonald. The device monitors the heartbeat and, if necessary, can shock it back into normal rhythm.
The defibrillator sends information about MacDonald’s heartbeat directly to his cardiologist. So when his defibrillator went off Oct. 27, his cardiologist told MacDonald to get to the hospital.
“We got to the emergency room, and I remember them wheeling me in. That’s the last thing I remember for about a week and a half,” he said.
MacDonald is still recovering, and it’s fine with him that he was unconscious for the drama of his treatment.
His defibrillator hasn’t gone off since he left the hospital in early November, and both his cardiologist and Lewkowiez are optimistic that the problem is fixed.
“They seem to think I’ll be OK,” MacDonald said.
Staff writer Karen Augé can be reached at 303-954-1733 or kauge@denverpost.com.
