Interventional cardiologists deliver artery-opening devices through the leg // Electrophysiologists zap wayward hearts into line // But traditional surgeons contend they still have plenty to do.
Is Heart Surgery History?
Bruce Peterson for Proto
You’ll just have to live with it.” That’s what doctors told Donna Colicchio about her recurring attacks of atrial fibrillation. But after 20 years, Colicchio felt the scope of her existence shrinking. Once, when taking her niece to a movie, she dropped to her knees outside the theater and couldn’t get up. Another time, she brought a table set for Christmas dinner crashing down when she collapsed in her Groton, Mass., home. She had an attack on a transatlantic flight and on a beach in Barbados.
Colicchio was what physicians refer to as a “lone fibber,” an otherwise healthy person with episodic atrial fibrillation, the most common kind of heart arrhythmia, a condition characterized by irregular heartbeats. More than 2 million Americans have AF, and many, like Colicchio, have no other heart condition, though they all have an elevated risk of stroke.
In fact, by the early 1990s, Colicchio could have been cured in one fell swoop. All she needed was to have someone saw through her breastbone, pry apart her ribs, put her on a heart-lung pump, stop her heart from beating, cut a maze of incisions through her heart’s atrial chambers and sew her back up.
But Colicchio, like most lone fibbers, wasn’t considered sick enough to justify the risks of open-heart surgery. Most people with AF either aren’t treated at all or are cared for with drugs alone, even though medication relieves symptoms only half the time and may cause serious side effects. Drugs didn’t help Colicchio, but finally in 2003, with the attacks continuing, her doctor told her there was another alternative. She underwent a new catheter-based, or percutaneous (through the skin, implying a puncture rather than an incision), procedure that, like angioplasty, approaches the heart via a peripheral blood vessel. Though she required a follow-up treatment, necessary in about half the cases, she has been symptom-free ever since.