The Health Sciences Education Building at the University of Arizona College of Medicine –...
Professor Credits UA Surgery/Cardio Team in Bypass Recovery
The UA is the only institution in Arizona and one of only a handful in the nation to offer a type of minimally invasive surgery.
Students in professor Richard Michod's ecology classes and his colleagues in the University of Arizona department of ecology and evolutionary biology would have a hard time believing that he is three months into recovery from heart bypass surgery.
In late October, Michod, who is 60 and an avid sailor, first noticed chest pain while sailing around San Diego. A few days later, he found he was unable to keep pace with his regular morning swim routine. His fiancé knew immediately that something was wrong and urged him to seek medical attention.
Michod landed in the care of Drs. Molly Szerlip and Mark Friedman, cardiology interventionists at The University of Arizona Medical Center. After an angiogram, he learned he had three blocked heart arteries that required surgery and/or stenting to restore normal blood flow to the heart.
"It was the first time I learned I was ill," said Michod, who at age 40 made some lifestyle changes after doctors told him he had high cholesterol. Those changes would serve him well in his recovery from surgery for his heart disease.
"When I learned I had high cholesterol 20 years ago, I was already exercising a lot. I consider myself fit – except I had this illness and didn't know it. One week after I visited Dr. Szerlip, I was on the operating table," Michod said.
Michod, who had just paid for a December sailing trip to the Virgin Islands with his fiancé, was presented with options that included a pioneering, minimally invasive hybrid coronary artery bypass graft procedure offered by Dr. Robert Poston, UA chief of cardiovascular and thoracic surgery.
In a traditional coronary artery bypass graft, a full incision down the chest is made to open the ribs for access to the heart and arteries. During the surgery, the surgeon takes a segment of a healthy blood vessel from the chest, leg or arm and attaches it to the diseased artery to bypass the clogged area and create a new channel, allowing blood to flow freely again.
Michod's lifestyle choices made him an ideal candidate for a hybrid approach involving angioplasty and stenting on two arteries along with a minimally invasive, robot-assisted coronary artery bypass graft on another artery – a pioneering surgery that avoids opening the chest, relying instead on small incisions between the ribs.
The minimally invasive coronary artery bypass graft surgical approach is a recent development, and its track record is not as established as that of traditional bypass surgery.
Treatment choices differ with age, overall health, the number, location and severity of the plaque buildup in the coronary arteries, and any previous treatment the patient has had. But thanks to recent recruitment efforts at the UA, it is an option offered now on a case-by-case basis.
Poston, a professor of surgery at the UA, credits the UA College of Medicine department of surgery chairman Dr. Rainer W.G. Gruessner for his leadership in recruiting doctors who can perform state-of-the-art procedures, including minimally invasive, laparoscopic and complex surgery, as well as solid organ, composite tissue and islet transplants.
Poston has performed the minimally invasive, robot-assisted heart bypass surgery more than 500 times. With his expertise, the UA now is the only institution in Arizona and one of only a handful in the nation to offer the minimally invasive surgery.
The typical recovery time for the minimally invasive bypass surgery is three to six days in the hospital with three weeks to two months of post hospital recovery time – a time period that fit well with Michod's plan to sail the Virgin Islands.
The standard of care for bypass surgery with the full incision down the chest and its recovery time can take twice as long both for hospital stay and post-hospital recovery time.
Michod's surgery took place on Oct. 31. He was discharged from the UAMC intensive care unit on the same day, and he left the hospital three days after his surgery.
"I was very tired in the weeks following the surgery, and my balance was not very good. I was worried about the sailing trip and the balance issues with secret fears of being out in the middle of nowhere and several days from an emergency room," Michod said.
However, the December sailing trip went very well – he gained confidence and skill with each passing day on the boat. But he still has little struggles each day that remind him of the seriousness of his post-surgical care.
"I am feeling much better," Michod said. "I'm still not 100 percent, and I am not yet doing all the things I could do, but I am getting stronger. It says a lot about the talent at UAMC. They have a very caring team – Drs. Poston, Szerlip and Friedman are tops."