NEWPORT BEACH : Procedure Replaces Emergency Surgery

A 37-year-old Costa Mesa man was released Wednesday from Hoag Hospital, after undergoing an innovative procedure that is a substitute for emergency coronary artery bypass surgery.

It is the first time the non-surgical procedure has been performed in the county, although several other local hospitals expect to offer it in the next few months, officials said.

The man, whom hospital officials declined to identify further, suffered a heart attack several weeks ago, and underwent angioplasty--a procedure using a balloon-type device to enlarge blocked arteries--at another hospital.

However, last Thursday the man experienced chest pains, diagnosed as angina, or heart pain, and was taken by ambulance to Hoag. Instead of performing coronary bypass surgery to save the man’s life, Hoag surgeons Subbarao Myla and Steven Schiff reinflated the artery using angioplasty and then inserted a tiny, stainless steel coil called Flex-Stent to keep the obstructed artery from collapsing. The one-hour procedure, performed using a local anesthetic, was approved for use by the Food and Drug Administration in early June.

The patient, according to Myla, will be able to return to work “in about one week instead of the six weeks to three months that would have been required had he undergone the surgery.”

In addition, hospital officials said, the cost of the Flex-Stent procedure is considerably less than the cost of coronary bypass surgery.

The coil will remain in the patient’s body, according to Dr. Joel H. Manchester, medical director of cardiology at Hoag’s Heart Institute. Within a few weeks, Manchester said, the body will coat the spring with tissue in much the same way it does with heart pacemakers.

“Until now, the only other option patients with abrupt closure or threatened closure during angioplasty had was to undergo emergency coronary artery bypass surgery,” said Manchester, noting that 2% to 11% of patients with coronary artery narrowing cannot be treated by angioplasty alone.

Four Hoag Hospital heart surgeons, including Manchester, have completed training in the procedure. Surgeons at UCI Medical Center and St. Joseph Hospital, both in Orange, are undergoing training and expect to offer the procedure in the next few months, officials there said.