The best medical technology of the day is quite often not the
best of the future. The cardiologists in the cardiac catheterization
suites at Genesis Medical Center, Davenport, have created a culture of
innovation.
Because of this culture, along with the high volume
of catheterization procedures being done each year at Genesis, the
catheterization team is often selected to participate in clinical
trials.
“This is a program willing to push the envelope to find
new methods benefiting patients,’’ said Eric Dippel, MD. “You need a
desire to do things differently to see if they can be better. That
desire comes from an entire team. The physicians, the hospital, and
Genesis Health System want to be leaders, not followers, when it comes
to innovation.’’
Participation in clinical trials is not unusual
within the Genesis Health System. Dozens of trials may be going on at
one time for cancer, orthopedics, and heart patients. The trials often
allow patients to stay close to home and still receive new advancements
in care.
One of the groundbreaking trials going on at Genesis is
a nationwide study of dissolvable stents to open heart arteries. No
other hospital in Iowa, or in the region, is participating at this time.
Patients who have an artery that is constricted have increased risk
of more serious heart disease. Patients who meet the criteria of the
study may be asked to participate in the study of stents that are in the
artery only temporarily before dissolving.
Cardiologist Nicolas
Shammas, MD, is the principal investigator at Genesis for the clinical
trial of ABSORB, which is called a Bioresorbable Vascular Scaffold
(stent) by manufacturer Abbott Laboratories. “What are the advantages?
The hope is that there will be reduced clotting with these stents,’’ Dr.
Shammas said. “Second, if there is a need for bypass surgery some day,
there will not be a stent there to hinder or prevent doing the bypass.
Third, there may be less need for the use of blood thinners for long
periods of time. Those are the advantages everyone is hoping for with
bioresorbable stents.’’
Studying Dissolvable Stents
The dissolvable stents are inserted with the same procedure as the
mesh, wire stents now used in most procedures. The dissolvable stents
are also coated with an immunosuppressant drug to prevent re-narrowing
of the artery. The major difference is that the wire stents remain in
the vessel. The ABSORB stents disappear within two years, leaving only
the drug treatment.
“It’s a blind study so the patients don’t
really know what they are getting, but it’s not like they are getting
something inferior,’’ Dr. Dippel explained. “They are getting the best
standard-of-care for today. The stents carry the same drug that the
conventional drug-eluting stents have.”
“The difference is the
hope of less scarring, returning the artery to a more natural condition
without the metal stent, and the improved ability to do bypass surgery
should it be needed later. A metal stent stays in and can complicate a
bypass surgery.’’
Dr. Dippel agreed with Dr. Shammas that
patients in the Quad Cities are not reluctant to try something
different. “There may be some people who are still skeptical and
reluctant to try something different, but others like the thought of
getting something new,” Dr. Dippel said. “They see the big picture of
doing something for future patients by participating in a clinical
trial.’’
Another Trial Closes
Another
clinical trial of stents recently closed. Dr. Jon Robken was the
principle investigator at Genesis for the EVOLVE trial to study a stent
that carries the drug selectively to the wall of the artery. The drug is
absorbed, and the bare stent remains.
Dr. Shammas said he has
spent much of his medical career in research and clinical trials.
“Research has been my life’s work in medicine,’’ he said. “It’s exciting
to be at a place where we have a great team capable of participating in
clinical trials. We’re chosen to participate because of the skill of
the people here and the high volume of procedures done here.’’
New Genesis Heart Surgeon
Helped Save Music Star’s Life
Eight media trucks parked around the block at the University of
Texas-Houston Medical Center was not a rare event. The medical center is
highly regarded and is accustomed to having celebrity patients. After
all, Congresswoman Gabrielle Giffords went through rehabilitation at the
medical center after she was shot.
Dr. Cornelius Davis
III was returning to the hospital after time away and was asked if he
knew what was going on. “They told me someone named Emilio was a patient
and that was a big thing. I had no idea who Emilio was at the time,’’
Dr. Davis said. Dr. Davis, who has joined the heart surgery team at
Genesis Health System, quickly found out how important Emilio Navaira
was.
The Grammy Award-winning Tejano artist, who performs using
only his first name, was near death in the hospital after his tour bus
was virtually demolished in a March 2008 accident. This was big news in
Houston and in the world of music.
Dr. Davis was about to play
an important role if Emilio was going to recover. More than 30,000 fans
contacted bnetradio.com, a Houston-based Tejano Internet radio station,
with their prayers and best wishes for Emilio’s recovery. Fans kept
watch around the hospital during the crisis. “Little did I know how many
people cared. I didn’t know his music,’’ Dr. Davis said.
The
two influences — medical school and residency — produced a heart
surgeon who is dedicated to less invasive procedures when they are right
for the patient and a patient’s condition.
Dr. Davis was asked to look at a radiology image taken of Emilio’s
chest. He found that Emilio’s injuries from the accident included an
aneurysm the size of a honeydew melon on Emilio’s lung. A fracture of
his ribs had caused the aneurysm.
He had already been there
four or five days before I was consulted. I didn’t want to have to
operate on him because of the risk,’’ Dr. Davis said. “What we were
able to with all the coils we could find was get the aneurysm clotted
off without surgery.’’ Dr. Davis’ procedure likely helped save Emilio’s
life.
Innovative Procedures
Dr.
Davis is accustomed to treating celebrity patients. He has performed
heart procedures on a prime minister, entertainers, CEOs, and major
league professional athletes. He also is accustomed to using innovative
procedures to save hearts and lives.
He is a product of the Duke
University Medical School, where he was attracted to heart surgery
partly because of influential mentors. “At the time, there were very
charismatic heart surgeons there. They made heart surgery look like the
most fun and the coolest thing you could do,’’ Dr. Davis explained.
“When I was training in heart surgery in New York, it was all about
faster, smaller, more innovative procedures. There was a huge push for
minimally invasive procedures.’’
Mentors Influence Dr. Davis
The two influences — medical school and residency — produced a heart
surgeon who is dedicated to less invasive procedures when they are
right for the patient and a patient’s condition. Minimally invasive
procedures usually result in shorter hospital stays and shorter
recoveries for heart patients.
Dr. Davis moved to the Quad
Cities this summer partly so that his wife, Cherylynne, would be closer
to her family in the Chicago area. He also was attracted by the team he
was joining, including Dr. Nicholas Augelli.
“I recognized that
Dr. Augelli and the other people already here at Genesis were a very
skilled team. If the people within the program are not skilled, it
drags a program down,’’ he said. “The right team is in place at Genesis.
We can do a lot of good things for heart patients in the Quad Cities.’’
To
reach Genesis heart surgeons Dr. Davis and Dr. Augelli, call
563-421-3990. For information about clinical research at Genesis, go to www.genesishealth.com/research.