HJAR May/Jun 2022

HEALTHCARE JOURNAL OF ARKANSAS I  MAY / JUN 2022 55 Thurston Bauer, MD CHI St. Vincent Heart Institute HEALTHCARE is a journey that never truly reaches an end. From new skills and ap- proaches to hyper-focused and specific disciplines, there are always improvements on the horizon to ensure that our mission to provide quality and compassionate care is fulfilled. Much like the effects on many other aspects of daily life, advancements in technology have proven to be increas- ingly influential in the continuous journey of healthcare. At the CHI St. Vincent Heart Institute, the latest treatments and technol- ogy for heart disease have given our team of cardiologists, surgeons, and heart specialists the opportunity to make very real impacts in our patients’ lives. One of those lives is Alabama native and former Marine, Luke Oliver. Suffering from a severe case of COVID-19, Luke was in dire need of extracorporeal membrane oxygen- ation, or ECMO treatment, but there were no beds or machines available in Alabama to help him. After hearing of Luke’s case from a nurse who stumbled upon a Facebook post detailing his condition and a plea for help, we sprung into action and facilitated his transfer to CHI St. Vincent Infirmary in Little Rock just a few days later. Luke was in rough shape when he arrived in our care, and standard treatments proved to be inconsequential in our fight against his relentless case of CO- VID-19. I truly believe he would have been days away from death without ECMO, and at that point, we had no choice but to take him to the operating room and immediately begin treatment. When it cmes to saving lives, ECMO has proven to be one of the most influential ad- vancements to heart surgery in recent years. ECMO is a form of temporary cardiopulmo- nary support for patients recovering from heart failure, lung failure, and other critical- ly ill conditions. The ECMO circuit removes blood from one of the large central veins, oxygenates that blood externally, and then returns that blood under pressure to either the venous or arterial circulation depending on the mode of support indicated. In addition to recovery from heart failure, lung failure, and heart surgery, the ECMO machine is used for a variety of different con- ditions, including cardiogenic shock, severe air leak syndrome, acute respiratory distress syndrome, and for support during high-risk procedures in the cardiac catheterization lab. It can also be used as a bridge option to fur- ther treatment such as a heart assist device or for patients awaiting lung transplant. It’s not an exaggeration to say that ECMO treatment has given us the opportunity to save lives that we couldn’t have saved just 10 years ago. Luke’s ECMO journey was an emotion- al roller coaster, and his heart stopped on us several times, but he never gave up the fight. The typical stay for a patient on ECMO is anywhere from a few days to potentially a week. Luke, on the other hand, spent a total of 33 days on the ECMOmachine to help him overcome the damage done by COVID-19. The coronavirus had destroyed parts of his lungs so much that air was leaking out. It was a grueling process that lasted nearly four months at CHI St. Vincent Infirmary, but Luke made a full recovery and returned home to Alabama with a new lease on life and renewed hope. Luke was facing a life-or-death situation, and the power of advanced technology and comprehensive care made all the difference. Advancements in tools and techniques are evident across the world of heart care. The MitraClip has provided a new treatment for patients with mitral valve regurgitation, and those with severe heart valve disease now have a less invasive option with transcath- eter aortic valve replacement. While these improvements have given doctors an op- portunity to make very real impacts on our patients’lives, wemust also recognize that the healthcare journey never ends. Techniques, procedures, and equipment will continue to evolve with new improvements and innova- tions always on the horizon, making a differ- ence in lives like Luke’s every day. n Thurston Bauer, MD, is a cardiovascular and thoracic surgeon with the CHI St. Vincent Heart Institute and surgical director of advanced heart failure and me- chanical circulatory support at CHI St. Vincent Infir- mary. In addition to his role in more than 1600 heart operations every year, Bauer helped build the CHI St. Vincent LVAD (left ventricular assist device) and ECMO (extracorporeal membrane oxygenation programs).