Loyola surgeons use new, less invasive catheter technique to treat cystic fibrosis

Loyola University Medical CenterSep 3 2011

Cystic fibrosis patient Daniel Sammons had undergone a successful double lung transplant at Loyola University Medical Center, but he still had one major health issue.

There was a severe narrowing in a large vein, called the superior vena cava, which returns blood to the heart from the head, neck and arms.

Sammons, 19, would turn purple when he sat or stood up. He suffered migraine headaches, and couldn't bend over without passing out.

Because of the lung transplant, a traditional open surgery to repair the vein was considered too much of a risk. So vascular surgeon Dr. Ross Milner, working with cardiothoracic surgeon Dr. Robert Love, used a newer and less invasive catheter technique.

Using catheters, Milner delivered a device called a stent graft, which opened the vein and restored normal blood flow.

Milner heads a team of vascular surgeons who are using stent grafts and other minimally invasive devices and treatments to treat vascular disorders.

Such endovascular procedures are significantly less invasive than traditional open surgery. Patients recover more quickly, with fewer complications and smaller scars.

Sammons, who missed an entire school year due to his illness, graduated last June from Bolingbrook High School and is beginning his freshman year at Benedictine University.

"This is the best I have felt in years," he said. "Dr. Love, Dr. Milner and all my other doctors have really kept me going." Sammons was born with cystic fibrosis, an inherited disease that affects the lungs and digestive tracts. It causes the body to produce a thick, sticky mucus that clogs the lungs. Before his 2009 lung transplant, Sammons' lungs were working at only 16 percent of capacity, and he required supplemental oxygen. The lung transplant, performed by Love, was a big success. "My lungs are perfect now," Sammons said. "I can outrun half my friends."

However, before his lung transplant, Sammons required medications that were delivered by catheters to the vena cava. This caused irritation to the vein, leading to scar tissue that narrowed the vessel to just 2 mm. and severely restricted blood flow. Normally, the superior vena cava is 10 to 12 mm wide.

Using catheters inserted through the right groin and right jugular vein, Milner guided the stent graft to the section of the vena cava where scar tissue had narrowed the vessel. The stent graft is a tube about 4 cm (1 ½ in.) long and 1 cm. wide. It is made of stainless steel and Gore-Tex, and expands after being released from the catheter.

Milner and Love carefully planned the complex procedure. In the event there were severe complications, Love was prepared to convert the procedure to an open surgery if necessary. They performed the procedure in Loyola's new hybrid operating room, which can accommodate both a minimally invasive procedure and an open surgery.

Fortunately, everything went as planned, and open surgery was not needed.

"This was a great demonstration of a multi-disciplinary collaboration," Milner said. "It also illustrates the advantage of having a state-of-the-art hybrid operating room."

Sammons has been hospitalized 56 times over the years. In addition to the lung transplant and vena cava repair, he has undergone surgery at Loyola for problems with his stomach and nose.

"I finally have all the things that were bugging me under control," he said.