One of our favorite things to do is highlight Nebraska Medicine colleagues who “save the day.” This story certainly fits that category. On June 25, a patient who was admitted three days earlier, began declining and was transferred to the ICU. This patient suffered from aortic stenosis, a condition where the aortic valve becomes so calcified, it narrows and makes it difficult for blood to travel through the value and out to the body.
“People with aortic stenosis are very sick,” says Julie Ciaccio, lead nurse, Cardiac Cath Lab. “They experience a lot of difficulty walking short distances. It greatly impacts their daily life.”
Michael Moulton, MD, thoracic and cardiac surgeon, evaluated the patient on June 26, which was a Sunday, and determined the 37-year-old needed a TAVR procedure. A Transcatheter Aortic Valve Replacement is an alternative to open-heart surgery, where surgeons insert a valve through the femoral artery in the leg, and insert the replacement valve into the aortic valve’s place. This allows a significant increase in cardiac output for the patient.
“His blood pressure began to drop, requiring increased medications to keep his blood pressure up and he went into cardiogenic shock,” recalls Dr. Moulton. “An emergent TAVR was the only strategy to save his life.”
Dr. Moulton faced a problem, though. He needed the specially-trained staff to come in on their day off. Three colleagues, Michelle Didier, Cardiac Cath Lab nurse (who was on her way to church), invasive cardiology technologists Brittney Smith, (who was home with her two small children), and Ali Hultquist came in to help with the procedure, even though they were not on call.
“Their call of duty—well above and beyond that expected—was invaluable in saving this man’s life,” says Dr. Moulton. “A TAVR procedure, and especially this particular case, is very complex. In fact, a TAVR in the setting of having a prosthetic aortic root replacement has only been recorded in medical literature a few times. To perform this on a Sunday in an emergent setting required our “A” team. With Michelle, Ali, Britney and the rest of the OR team, and the anesthesia staff, we definitely had the ‘A’ team.”
“I am continually impressed by my staff’s commitment to their work,” says Becky Paar, manager, Cardiac Cath Lab. “Each day I witness our team’s passion in caring for our patients.”