Pikeville Medical Center (PMC) has made medical history in Kentucky by successfully performing the state’s first minimally invasive AngioVac procedure to treat a life-threatening mitral valve infection in a high-risk patient who was not a candidate for traditional open-heart surgery.
The innovative procedure was led by Dr. M. Paul Randhawa, board-certified cardiothoracic surgeon at the Heart and Vascular Institute of Eastern Kentucky at PMC, in collaboration with a highly specialized, multidisciplinary care team. This included interventional cardiologists Dr. Maen Assali and Dr. Joseph Choo, and cardiac anesthesiologist Dr. Joshua Hensley, who guided the procedure with meticulous precision utilizing transesophageal echocardiography (TEE).
Additional key contributors to the success of this complex case included PMC’s perfusionist, the Cardiac Cath Lab team, and nursing care teams from the Heart and Vascular Institute. A clinical specialist from AngioDynamics, the company that developed the AngioVac system, also provided crucial guidance during the planning phase.
The patient, who had previously undergone open-heart surgery and was undergoing dialysis, presented with an infected mitral valve—a condition that typically necessitates open-heart surgery. However, due to the patient’s complex medical history, conventional surgery posed an unacceptably high risk.
“This patient’s condition was critical, and traditional surgical options were not viable,” said Dr. Randhawa. “Utilizing the AngioVac system allowed us to remove the infection without subjecting the patient to the risks associated with open-heart surgery.”
The AngioVac system, developed by AngioDynamics, is a vacuum-assisted device designed to remove unwanted intravascular material. While commonly used for right-sided heart infections, its application in left-sided infections, particularly involving the mitral valve, is rare and complex. This procedure marks the first for such a case in Kentucky, another remarkable feat for the Heart and Vascular Institute of Eastern Kentucky at PMC.
Dr. Assali emphasized the importance of teamwork in the procedure’s success. “The complexity of accessing the left side of the heart and the patient’s medical condition required meticulous planning and collaboration among our multidisciplinary team,” he said. “Dr. Randhawa’s expertise and experience with the AngioVac system was instrumental in navigating this challenging case.”
Every aspect of the procedure, from diagnosis to execution, was coordinated with extraordinary attention to detail, safety, and patient care. The case was extensively reviewed and planned in consultation with the AngioDynamics clinical team, ensuring all contingencies were addressed.
“This case exemplifies PMC’s commitment to providing cutting-edge, patient-centered care,” said Dr. Randhawa. “By leveraging advanced technology and fostering interdisciplinary collaboration, we can offer life-saving treatments to patients who might otherwise have limited options.”
The Heart and Vascular Institute of Eastern Kentucky at PMC is dedicated to delivering comprehensive cardiac care through a team of highly skilled specialists, healthcare professionals, coupled with state-of-the-art technology and advanced medical equipment. This recent achievement underscores the institute’s role as a leader in innovative cardiovascular treatments in the region.
For more information or to schedule an appointment, please contact the Heart and Vascular Institute at (606) 430-2201 or visit www.pikevillehospital.org/heart.
