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Medical News

Michigan Heart Surgeons

Perilously Close to Dying, DMC Heart Hospital Patient Was Saved by Pioneering Lung-Clot Removal Procedure

The Red Wings were flying down the ice, sticks at the ready, intent on scoring their next goal.

But Colin J. Poole couldn’t join the thousands of fans who were screaming their lungs out on that chilly November night last year.

Because Poole, a recently retired university math-and-science professor who lives in suburban Clarkston, was hanging onto a railing at Detroit’s Joe Louis Arena ... and he was fighting desperately for air.

Having just climbed halfway up a steep flight of stairs, the 53-year-old Poole was gasping audibly.  On each intake of breath, a giant’s hand squeezed his heaving chest, making him wince with pain.

For several minutes, he struggled on the stairs. But then the symptoms gradually subsided and he was eventually able to return to his seat.

During the next few days, however, the breathlessness and the chest pain returned periodically ... along with a growing sense of anxiety and what Poole would later describe as “a feeling of imminent doom”.

And then, about a week after the Red Wings game, as the former math teacher wandered through the brightly lit produce department at Hiller’s Market on West 14 Mile Road in Commerce Township, he felt the symptoms beginning again. Soon they were intense.  Overheated and dizzy, he staggered out of the supermarket, shuffled fifteen or twenty steps down the sidewalk – and then collapsed in a heap.

Terrified, his wife Elizabeth and his 22-year-old son Michael were instantly kneeling beside him.  Frantic, they held his hands and waited for the blessed sound of the approaching sirens.

Less than an hour later, the half-conscious patient was already undergoing tests in the Intensive Care Unit at the nearest medical facility, DMC Huron Valley-Sinai Hospital, located only a short distance from the supermarket.

The Huron Valley-Sinai heart-care physician in charge that day – Dr. Craig M. Sharkey – didn’t hesitate.  After examining the patient and reviewing test results (including, especially, the results of a high-tech “CT scan” of his chest), Dr.  Sharkey informed the struggling Poole and his family that he was experiencing a pulmonary embolism.

In other words: a giant blood clot had formed in Poole’s deep leg veins ... and had then traveled through his circulatory system.  Now it was almost completely blocking the major artery that moved blood in and out of his lungs. Reacting quickly, Dr. Sharkey called for “anticoagulant” medications – powerful doses of warfarin and heparin.  These substances would ease the clot a bit ... but they couldn’t break its lethal stranglehold on Poole’s lungs.

“There’s no time to spare,” Dr. Sharkey told the patient and his family.  “We have to get you to a medical facility where they’re equipped to care for you.”

He was already reaching for the nearest telephone.

Minutes later, they were loading Poole into a clattering helicopter for the 15-minute ride to the Detroit Medical Center’s Cardiovascular Institute (CVI) – where a team of specialists was already gowned and scrubbing down in anticipation of the battle that lay ahead.

What Dr. Sharkey hadn’t told Colin Poole was that the lung clot was the largest he’d ever seen in a patient ... and that the math-science teacher’s chances of survival were perilously low.

The clock was now ticking.

The doors of the chopper slammed shut, and soon it was rising from the tarmac.

The date was November 19th, 2013 – and the race to save Colin Poole’s life was now fully underway.

Armed With the Experience – and the “Courage” –

To Handle the Most Difficult Cardiovascular Cases

Deep inside the CVI’s humming catheterization laboratory – today a key cardiac care unit at the brand-new DMC Heart Hospital complex in mid-town Detroit – the blood-clot team was awaiting the patient’s arrival.  Led by Dr. Mahir D. Elder, a veteran cardiovascular specialist and also the medical director of the new $125-million Heart Hospital’s Cardiac Care Unit, that award-winning team has in recent years performed thousands of successful procedures for patients with threatening arterial blockages of one kind or another.

But today’s emergency procedure would be especially challenging

It’s no accident, Dr. Elder would later explain, that pulmonary embolism (PE) causes 15 percent of all the sudden deaths in the United States each year.

Although the exact causes of this often genetically-linked disorder remain unclear, its devastating impact is starkly evident:  more than 60,000 of the 600,000 Americans affected by PE each year die from it – and frequently during the first hour or two after the blood clot reaches their lungs.

PE is often a “major medical emergency,” said Dr. Elder.  But then he went on to point out that the DMC Heart Hospital now has in place a highly successful set of procedures for rescuing patients from the lethal effects of such lung clots.

And one of those procedures – which calls for inserting a thin plastic tube, or “catheter,” into the patient’s circulatory system and then using it to “vacuum” the offending clot from an affected artery – was about to provide “the final line of defense” for the struggling Colin Poole.

“Because the clot was so large, we knew it would be difficult to remove,” said the 43-year-old Dr. Elder, who recently was named a “Healthcare Hero” by Crain’s Detroit Business for using his catheterization skills to prevent more than 1,000 needless limb-amputations in diabetes patients with circulatory blockages.

“There’s no question that Mr. Poole’s lung clot presented us with a major challenge,” said the Heart Hospital specialist.  “But after performing thousands of successful procedures for patients with cardiovascular blockages in recent years, we were confident that we could use our state-of-the-art high-tech tools and our knowledge and expertise to remove the clot and restore the circulation in Mr. Poole’s lungs.”

Quietly hopeful and fiercely determined, Dr. Elder was also feeling “very courageous,” he would say later, as the emergency medical team rolled Colin Poole into the Cath Lab.  “When you’re working on a highly complex case like this,” said the CVI expert, “you know you’re going to be tested – and you have to have the courage to say: ‘We will do whatever it takes to help that patient!’”

Using Two “AngioVac” Clot-Removers at Once

The first step in the procedure was to create a tiny incision in the patient’s thigh, then thread the flexible catheter into a large vein.  From there, Dr. Elder maneuvered the pliable device through Poole’s bloodstream until it was in position near the affected area of the lung artery.

From its perch inside the blood vessel, the catheter could then be used to introduce a tiny suction device – the “AngioVac” mini-pump – that would work to break up and then literally “vacuum” the pieces of the now-fragmented clot back down the catheter.

Because the embolism was so large and thick, however, Dr. Elder decided to insert a second AngioVac in order to double the amount of vacuum-power attacking it.

The results were soon apparent. Once the clot was gone and blood began flowing back into the patient’s lungs, the stress on his heart was relieved and he began to feel better almost immediately. After spending another day and a half in the hospital, Poole walked out the front door without requiring a wheelchair. And within another few days, he had begun to feel like his old self again.

Describing the procedure later, Dr. Elder noted that “this was the first time we ever used two AngioVacs at once with a patient ... and it may very well be the first time that approach has ever been used in treating a pulmonary embolism.

“But the outcome was very encouraging, and I do think that procedure illustrates why the CVI year after year is doing more of these complex cardiovascular cases than any other medical center in Michigan.”

According to Dr. Theodore L. Schreiber, the President of the new DMC Heart Hospital (where the CVI is now housed), Colin Poole’s successful outcome is “a terrific example of how the Heart Hospital has the high-tech resources, the expertise, the personnel and the will to help cardiac patients who are struggling with even the most difficult and challenging cardiac or circulatory issues.

“The launch of the Heart Hospital marks a transformative event in cardiac care in Michigan and the Midwest,” he added, a few days after Colin Poole went home to his enormously relieved family in Clarkston.  “Whether we’re talking about treating heart-attack victims with our highly regarded Cardio Team One program (in which a skilled cardiologist and staff are stationed at the hospital 24/7) . . . or about treating pulmonary embolism patients with new kinds of highly specialized procedures, the DMC Heart Hospital is already beginning to play an exciting new role as one of the world’s best heart care centers.”

And Colin Poole?

“I’m feeling very good, very energetic these days,” said the rejuvenated professor the other day.  “That was a difficult journey, to say the least . . . and I do feel very lucky that I wound up at the DMC, where they knew how to take such good care of me.”

Then, after a quick “thanks to the DMC and the truly amazing Dr. Mahir Elder, who have allowed me to go back to having a normal life,” Colin Poole pointed out that he’s a “passionate sailor” who loves nothing more than setting a course across one of Michigan’s gorgeous summertime lakes.

“I’m feeling better every day,” he said with a smile, “and right now I can hardly wait to get back out there on the water!”

Detroit Heart Doctors