FOR IMMEDIATE RELEASE 8/13/10
CONTACT: Jim Wozniak
(423) 230-8237
CARDIOLOGIST BECOMES FIRST TO PERFORM
RARE PROCEDURE AT HOLSTON VALLEY
KINGSPORT – Steven Smith, a 45-year-old Rogersville resident who has suffered from breathing troubles for years, is looking forward to a higher quality of life thanks to a successful procedure performed for the first time at Holston Valley Medical Center, Tennessee's No 1 hospital for cardiology.
On Thursday, Dr. Marc Mayhew, a board-certified interventional cardiologist with Cardiovascular Associates, performed a closure of an aortopulmonary fistula in the catheterization lab at Holston Valley. An aortopulmonary fistula is a congential condition that occurs when an abnormal blood vessel passes from the aorta to the pulmonary artery. In Smith's case, the vessel traveled to his left and right pulmonary arteries.
"This is important because the pressure in his lungs and heart may become elevated to dangerous levels," Dr. Mayhew said. "I was able to successfully repair the aortopulmonary fistula using a vascular plug."
Dr. Mayhew, who noted this procedure is rare, said it went perfectly and was completed in about two hours.
"The fistula is 100 percent closed," Dr. Mayhew said. "There were zero complications. I expect him to feel considerably less breathless immediately."
Dr. Mayhew gave Smith, who earlier had undergone an operation to close the fistulas between his coronary and pulmonary arteries at the University of Alabama-Birmingham, the option of returning there or being the first to have the procedure at Holston Valley. Smith chose Holston Valley and was rewarded with a successful procedure.
"I think it's further evidence that we're a high-quality cardiovascular program with superior technical skills and technologies that traditionally have only been available at major academic medical centers," Dr. Mayhew said. "Mr. Smith is a perfect example where the absolute most challenging case could have required him to travel five hours to UAB. But we're able to do this in his hometown."
That was important to Smith.
"I wanted to do it here so I didn't have to travel," Smith said. "I didn't want to go that distance. Dr. Mayhew said this would be the first time at Holston Valley. I was willing for them to do mine here if it would help me without my going to Alabama. Plus, it could help other people in the future."
Cardiovascular Associates, which has more than 30 specialists practicing in six area locations, is part of Wellmont Health System.
Dr. Mayhew said Smith has had shortness of breath since he was a child. At one time, his symptoms were attributed to asthma.
Several months ago, Smith developed chest pain, which led him to undergo a cardiac catheterization that showed abnormal connections between the coronary arteries and pulmonary arteries. The catheterization also showed blockage in his coronary arteries, so he underwent bypass surgery.
"The plan was to repair these abnormal arteries at the time of the bypass surgery, but they couldn't be identified in the operating room," Dr. Mayhew said.
At this juncture, physicians did not know about the problem between Smith's aorta and pulmonary arteries, so he was sent to the University of Alabama-Birmingham because of the complexity of his condition. The coronary to pulmonary fistulas were closed there, and Smith experienced relief initially. Then his breathlessness returned.
Dr. Tom Bulle, another physician at Cardiovascular Associates, diagnosed Smith's aortopulmonary fistula with a CT scan. Because of that discovery, Dr. Mayhew shared the success of Thursday's procedure with Dr. Bulle, saying his fellow physician was astute to look for other causes of Smith's symptoms.
Dr. Bulle asked Dr. Mayhew whether he could correct the problem locally instead of Smith going elsewhere. Dr. Mayhew was confident he could and worked with AGA Medical, the manufacturer of the Amplatzer vascular plug he used on Thursday to repair Smith's fistula.
Even though he had not performed this particular procedure before, it was not difficult for Dr. Mayhew to prepare. His specialized training contributed to his ability to repair Smith's fistula.
"The technique is not terribly different from other procedures I do as an interventional cardiologist," Dr. Mayhew said. "Today's procedure was catheter-based. All of my procedures are catheter-based. As far as the technical aspects, I would say that my coronary techniques and skills easily translate into the skills required to perform this procedure.
Now, Smith looks forward to a higher quality of life.
"Hopefully, my breathing will improve, and it will help make my life better and let me do more with my kids and grandkids," he said.
Dr. Marc Mayhew uses a monitor as he performs a closure of an aortopulmonary fistula at Holston Valley Medical Center.
Dr. Marc Mayhew performs a closure of an aortopulmonary fistula at Holston Valley Medical Center.
Dr. Marc Mayhew reviews Steven Smith's X-rays during a procedure to close his aortopulmonary fistula at Holston Valley Medical Center.
Dr. Marc Mayhew shows an Amplatzer vascular plug. He used one to close Steven Smith's aortopulmonary fistula
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August 12, 2010
Enjoy Tax Free Weekend! 
