SANTA CRUZ -- Local physicians now have another arrow in their quiver to fight heart disease. Doctors at Dominican Hospital are pioneering a less invasive surgery to treat atrial fibrillation, a condition that puts sufferers at higher risk for stroke.
The first patient in Northern California had the new surgery, called the thoracoscopic Maze procedure, in late October.
Atrial fibrillation, or afib for short, is the most common type of irregular heart rhythm. "The vast majority of patients with atrial fibrillation do extremely well with medical therapy (oral medications)," said Dr. Niel Sawhney, the cardiologist for the patient.
But for a small proportion, that's not enough. They continue to have symptoms -- shortness of breath, palpitations and are extreme fatigue -- despite medications.
Atrial fibrillation increases the risk of stroke because a steady heartbeat is what keeps blood moving smoothly through the body. An irregular heart beat allows blood to pool in the chambers of the heart, potentially leading to clots.
Those clots can move into the bloodstream, blocking blood flow when they get to small vessels. A stroke is a blockage of blood to the brain. Your risk of a stroke is nine times higher if you have atrial fibrillation. It's more common in older people and as the population of the U.S. ages, it will become more common.
For people who need open heart surgery anyway -- people getting a heart bypass or valve replacement -- doctors can address serious atrial fibrillation surgically.
For people without other problems, cracking open the chest and stopping the heart is too invasive, said Surindra Mitruka, the heart and lung surgeon who performed the new procedure. Mitruka is one of the few surgeons who knows it well enough to train other heart surgeons.
Like the older open heart procedure, the cardiac surgeon creates a pattern of burns on the heart. When they heal, they create walls that keep the electrical signal from the heart's natural pacemaker on a narrow steady path, Mitruka said.
The new surgery requires only three small cuts on either side of the rib cage. Mitruka threads instruments into the chest cavity and uses a camera to see where to make the burns.
It's been a month since the first patient at Dominican had her surgery and she's already feeling better. "Getting rid of the pain was a biggie," said the patient said, who asked not to be named.
Mitruka said atrial fibrillation can often be silent, showing no symptoms. He encouraged seniors to get regular checkups. Most cases of atrial fibrillation can be controlled with medications.
Bringing Mitruka and his rare skills to Santa Cruz was part of a larger collaboration between Dominican Hospital and Palo Alto Medical Group when doctors and administrators noticed many Santa Cruz residents were going to Palo Alto for heart surgeries.
Conrad Vial, director of Cardiothoracic Surgery for the Palo Alto Medical Group said, "It's part of a much broader agenda of cardiovascular disease management that is unfolding at Dominican, to the good of the community."