Prakash Chandran (Host): Dr. Eric Peck, a Cardiothoracic Surgeon at Dignity Health recently performed a heart mass removal surgery using the AlphaVac, an FDA approved mechanical aspiration device. His patient, Kimberly Marchant, was told she needed open heart surgery after discovering an eight centimeter blood clot in her chest.

However, thanks to Dr. Peck and the AlphaVac, she was able to undergo a minimally invasive procedure instead, avoiding any major disruption to her daily life. Keep listening to hear more about this groundbreaking technology and how Dr. Peck is changing the game in the field of Cardiothoracic Surgery.

Joining us to discuss today is Dr. Eric Peck, a Cardiothoracic Surgeon for Dignity Health and his patient Kimberly Marchant. This is Hello Healthy, a Dignity Health Podcast. My name is Prakash Chandran. So Dr. Peck and Kimberly, thank you so much for joining us today. I'm really excited to learn more about this procedure and the impact that it had on you, Kimberly. Dr. Peck, I'd love to get started with you. I know I mentioned AlphaVac up at the top, but can you talk a little bit more about this procedure and how it is performed?

Eric Peck, M.D.: Yes, of course. Thank you for having me today. This procedure is really fantastic in the sense that patients who would otherwise have had to undergo open heart surgery and all that that involves, in terms of the procedure; pain, time in the hospital and recovery is avoided by using basically a large tube that is inserted in the vein in the groin usually, but also can be inserted through a vein in the neck.

And this tube is then advanced into the heart chambers where there is a tip of which looks like a funnel and that is engaged upon a mass within the heart, and suction is applied. And that mass is removed through the tube, out of the patient, and essentially that's all it involves.

Host: That is pretty incredible. I've heard of I guess an angiogram, is that kind of the same type of methodology that is used for the AlphaVac?

Eric Peck, M.D.: Yes, it's the same idea in that you're accessing the heart through a blood vessel that is remotely located. The main difference in this case, is those catheters tend to be a very small caliber because they're engaging the coronary arteries that supply blood to the heart. And in this case, we're dealing with these large masses in the cardiac chambers. And so this tube is perhaps 10 times greater in diameter than those smaller catheters.

Host: Okay, so let's talk a little bit more about that new technology. There's obviously the tube that goes to the heart that's a little bit thicker than the one used in the angiogram, but what other technology can you share that is unique to this procedure?

Eric Peck, M.D.: So the procedure is always done with the AlphaVac device as well as what we call a trans esophageal echo. That is a scope that goes down the esophagus into this stomach area, which is directly behind the heart, and that is an ultrasound probe. That ultrasound probe is able to view the heart and its chambers and whatever abnormal mass may be present there.

And so using the images from the ultrasound probe and inserting this tube into the heart, we're able to direct that catheter up against the mass. And then essentially it is like a hand crank that we pull and that applies a certain amount of suction to the tube to engage the mass within the funnel.

We then are able to alter the, I'll say amount of suction that the device applies, once we have the mass engaged and then further administrations on the handle, will suction that material actually through the tube and out of the patient. And we can look with the ultrasound probe at the end of the procedure to make sure that we got everything out that we want to.

Host: Yeah, that's pretty amazing. There's kind of one for viewing and then the other for suction, like both basically in collaboration, making this process as comprehensive as it can be. Tell me, is Memorial Hospital the only hospital performing this procedure in Kern County?

Eric Peck, M.D.: Yes, it is.

Host: What type of impact do you think this procedure has for Bakersfield Heart patients?

Eric Peck, M.D.: Well, I think it certainly provides a new therapy that wasn't available here, to get patients healthy and get them back to their lives in a quicker fashion and less interruption to their lives. But also for those patients who may have been required in the past, to go out of town to try and get this type of treatment, now they can stay here with the support of their family and their community and have this treatment done while they're at home.

Host: Yeah, absolutely. And when we think about the right candidate for this type of procedure, can you share a little bit more about the patient that should be considering this?

Eric Peck, M.D.: Well, the patient's going to have, as I said, a mass within the heart. Now in Kimberly's case, this was a blood clot, but it can also be infections which can develop on the heart valves. It's a relatively common condition. And then and there are also rarely some patients who will develop tumors within the heart chambers.

And this device can be used in all of those settings to avoid the need for heart surgery. But, certain patients will be candidates for it and certain ones will not. And so it really is a decision that's made based on the imaging of the patient in collaboration with both the surgeon and the patient's cardiologist.

Host: So I imagine because you're not opening up the chest and doing it in this minimally invasive way, that the recovery time is faster. Can you share what the recovery time looks like for this procedure?

Eric Peck, M.D.: Yeah, of course. So the procedure lasts somewhere between one to two hours. Patient is under anesthesia for this. Essentially there's the one puncture site in the groin, which is closed up with a suture, and then the patient is wakened up from anesthesia. They go to recovery for an hour or two. They spend one night in the hospital and go home essentially with a bandaid in the groin. Typically, patients are back to normal life within a few days or a week.

Host: Wow, that is incredibly fast. So outside of the amazing recovery time, how do you feel like this procedure and using this technology impacts the lives of your heart patients?

Eric Peck, M.D.: Well, it's just a minimal interruption in their life. You know, I do open heart surgery all the time and open heart surgery is a fantastic tool we have to heal people, but it is a lot for the patient to go through. Patients typically will have what's called a sternotomy or have their breast bone split open and then they're on a ventilator for perhaps 10 or 12 hours that day.

They're in an ICU for a couple days with multiple different types of IVs, drain tubes out of the chest. They're in the hospital for approximately a week, and then even once they're discharged, it's really two months of not working and not driving and not doing too much with your arms to allow the sternum to heal before patients can really get back to normal life. So you can see what a vast difference this would be from the traditional procedure.

Host: Yeah, absolutely. Now Kimberly, I want to move on to you. You've obviously experienced this procedure and I have a lot of questions around that, but before we get into that, I'd love for you to start by just giving a little brief background on yourself.

Kimberly Marchant: Sure. Thanks for having me. I appreciate it. I am a single hardworking dog mom, and you know, I'm on the go a lot. I do a lot of things and I feel like being able to be part of this and have this procedure done, was just a complete and utter blessing for me.

Host: Yeah. It definitely sounds like it. Tell me a little bit about how you got diagnosed and what that experience was like and why this procedure was recommended.

Kimberly Marchant: I was having some symptoms. I was having like shortness of breath. I work at a hospital, I work with the trauma team. And some of them were saying, you just don't seem like yourself. And I just thought, you know, I've had COVID three times. I thought, maybe it's just, some adverse reactions from that, long haulers or something.

And something inside me was saying, you haven't seen your cardiologist since COVID and everything's been locked down, so, just was having those symptoms and thinking about that I was more tired than usual and just not my normal self on the go and whatnot. I made an appointment with the cardiologist and then the cardiology group that I go to said, let's do an echocardiogram. It's been a while. So they scheduled me for one. I had the echo done. Right then they had said I had a mass, so I have a pacemaker and I have two leads for my pacemaker that go into my heart. So at that point they considered it a type of mass. They thought, maybe a blood clot, they weren't quite sure. It was attached to the pacemaker lead, I believe, in the right atrium, if I'm saying that correctly, Dr. Peck and so decided that I needed to go for more testing, and that's how it went from there. Went to the hospital, did a couple different things of testing, and they said, you know, let's put you on a blood thinner, my cardiologist for a couple of months and see if it shrinks, and it only grew in size when I went back for the second echocardiogram. And then they said, we're going to refer you to a cardiothoracic surgeon, which was Dr. Peck.

Eric Peck, M.D.: Yes, she's correct. The chamber, where the mass was located is the right atrium. And the concern for her having that mass there is that if, God forbid the entire thing or even part of it, were to break off, that would end up traveling into the lungs and cause a condition called a pulmonary embolism.

And, sometimes they're mild, but in its most severe form, that can be a fatal complication. So it was a very serious condition and that's why her cardiologist referred her for something as big as an open heart surgery to remove that, to protect her life from that devastating complication.

Host: Now, Kimberly, when you were referred to Dr. Peck, tell me a little bit about how that diagnosis went and at what point this procedure came to light.

Kimberly Marchant: My first initial visit with him, Dr. Peck had discussed basically the surgery and how he can remove it and went over everything and it was really hard for me to fathom having to go through something so extreme as a surgery such as that. And so I had mentioned to Dr. Peck like, God, is there anything else? You know, is there's something that's just how my mind goes forward thinking of like, is there something we can do to just get it out or whatever. And at that time, nobody was really doing anything with the HVac here in Bakersfield. I had even asked a couple of the surgeons that I work with, and they're not doing it there, they don't have the equipment.

They had heard about it, but weren't doing it. It wasn't happening here in Kern County or Bakersfield. So, he sent me for a few more tests to see, make sure I didn't have anything else going on in my lungs, any blood clots. And we made a second visit after that. So it was initially after the first, my first visit meeting Dr. Peck, and then coming back for the second visit with him. And that's when he had said, I've been thinking a lot about your case and had went into telling me in regards to how they could take it out with this invasive procedure. And I was just a hundred percent on board. I just heard in my mind, oh, I don't have to do surgery.

I don't have to be off of work for three months. I don't have to not being able to not drive for two months. And there was a lot involved in my life to be able to have me put down for that amount of time. I just couldn't even fathom it. So I was on board a hundred percent. As soon as he mentioned it was like, do you want to do it? And I was like, yes, absolutely.

Host: I mean, going from having to open up your chest to, this new procedure that is minimally invasive must have just felt like such a relief. And, when Dr. Peck was talking to you about it, like how did you feel just in terms of your confidence level that this was going to work?

Kimberly Marchant: Oh my gosh, I was so ecstatic and so happy about it. I just immediately thought, I can like get this procedure done and to just be in the hospital for a day and I don't have to miss out on different things and aspects in my life or just in life in general. So I was super ecstatic. I was, like I said, a hundred percent on board and I was just so thankful that he took the time, you know, and all that, that he went through to research this and decide we're going to do it.

I'm just was a hundred percent on board and just really grateful. I mean, I think that it's amazing, the technology that's coming out these days and things that can be done so, I'm just super happy with the way that everything turned out. Super excited. I mean, I still am like in disbelief that seeing what came out of me that is like actually out of me and that I wasn't in pain or anything, and that everything in my life didn't stop basically for three months.

Eric Peck, M.D.: Yeah, I'll just add to that, we are constantly evaluating new technology and how we can apply that to our patients in the most appropriate way. And so I was aware of this AlphaVac device and I've had a number of conversations with both and, and the people who make this device. And I knew there was a patient population that could benefit from this. Because it was new for us, we really wanted to try and identify a patient that wouldn't be as challenging, let's say cause it was the first time we were going to be doing it.

And so her imaging and where the mass was located, we really thought this is like the perfect case to try and extract this mass for the first time. It's located in the right atrium, which is the first chamber you get to when you put that tube up into the heart, so if there's less manipulation, it would be the easiest place to get to.

The way her mass was partially attached to the lead, but mostly free, we felt that there was a very high likelihood that we would be able to remove it. So in conversation with my cardiology colleagues, we just thought everybody was in agreement. Kind of like Kimberly. You heard her say, yes, this is it. This is the person that is going to really benefit from this. We had a high expectation that we were going to be successful, and it just turned out great.

Host: Yeah. It's so amazing to hear the story. Now Kimberly, Dr. Peck painted a very nice picture of what recovery time is like, just like basically an overnight band-aid and then week recovery process. Tell us what was your recovery process like? Was it as, as he explained?

Kimberly Marchant: It was exactly as he explained. I was pretty surprised. I mean, I didn't, other than being a little groggy from being put under, which I was very glad that I was put under, I'm kind of like anxiety and weird about being awake when procedures are done. So other than that, there was no pain. I enjoyed my hospital stay because as I told Dr. Peck, I was like, please keep me in the hospital at least a day or more, or whatever, cause I'm the single mom and I do everything for everyone else. So it was a nice peaceful, low moment for me. But, I had no pain in the little incision site, in the groin area, I had no pain.

I mean, it was like a walk in the park for me anyway. It was, you know, I'm not sure, during the time I was asleep and the procedure and how all I know that that went well, but on the other end of the spectrum. But it was great. I was able to come home and I spent a few days off of work just because I wanted to, and I was up doing laundry and getting things done.

And for the first time I had noticed that when I would exert myself around my home, I didn't have the shortness of breath that I always had before. So that was like one thing that I really noticed right away. But it was amazing. It really was.

Host: Yeah, that is just so amazing to hear, and especially as a single mom, just the amount of responsibility that you have and just hoping that this goes well and that you can get back to the day-to-day quickly must have been just so important to you, and it really sounds like things just went very smoothly.

Kimberly Marchant: Yeah, absolutely. I mean, Dr. Peck and the whole team, everybody that was involved was just extremely patient and kind and just wonderful with me. I think they were just excited as I was, when I woke up, I was like, is it gone? You know, is it removed and I mean, it's just amazing and I'm so thankful for just having my life back again basically.

Host: Yeah, there's going to be people listening to this, potentially other heart patients who might need this procedure, and maybe they're a little apprehensive just because it is maybe a little new compared to the old traditional way. What might you say to them just around your experience and potentially alleviating some of their concerns?

Kimberly Marchant: Yeah, absolutely. I think that, for me, just knowing the difference of what was explained to me, if I would've had to have had surgery and the recovery time, and taking so much time out of life and also being in the pain that you would have to be in during, while your body's recovering.

I mean, it's just a no-brainer. I think that anybody that may have a little bit of fear or anxiety, I think if you weigh the pros and cons of each one of the outcomes, having the procedure done that I had done, it's just absolutely amazing. I don't think anybody should be afraid about that.

But I think, going into it and then just realizing that the time that you're going to get back so quickly with your family, and not only that, just the process of it being removed so quickly, depending on whatever it is that somebody has to have removed. That right there, I mean, like Dr. Peck saying, having, you know, a life-threatening type of thing, the way that mine was and could have turned into something more serious. So, for me, I felt like having it taken out through the way that Dr. Peck had done the procedure was also much quicker so than having to go through surgery. I think just weighing the pros and cons.

Host: You've already spoken to this a little bit, but trust is such a big part of going through a procedure like this. I know that obviously you had a lot of trust that things were going to go well when Dr. Peck took the time to research it and present it to you, but, talk to us about your impression of Dr. Peck through this process. Even, after the procedure and through recovery.

Kimberly Marchant: So, like I said, I work in the medical field, I work with a lot of doctors. I'm a trauma site coordinator, and I realize, going through the procedure and just the amount of patience that Dr. Peck had with me and just his kindness, his bedside manner. He's just awesome. He's just really was just so wonderful towards me.

Any concerns or any anxieties or anything that I had, I mean, he was just right there, came in and checked on me, made sure I was okay and if I needed anything. And, I just think that he has that patience within him to be able to listen to people and really hear them and listen to, you know, a patient or someone that has an issue. And then just going into the whole area of what can I do to make them better in any way.

Eric Peck, M.D.: Thanks, Kimberly. That's really kind of you to say. I would also just like to add there that we always go into this type of a procedure with the expectation that things are going to go great and we're going to get this mass out and the patient's going to go home the next day. But just so that if people are wondering, what if, and I'm worried about it, we always have all the contingencies available.

Open heart surgery is always the backup and everything is there and everything is available, so patients are going to be safe and get through the procedure. We always hope it's with the intended minimally invasive approach, but everything is there and patients will be kept safe no matter what.

Host: Now, Kimberly, final question for you. Again, you've spoken to some of the impact this has had, but just broadly speaking from the time you got diagnosed to where you are now, can you speak to how this has impacted your life?

Kimberly Marchant: I feel like it's really given me a lot of my life back. Like I said, not being able, just walking from like my office to getting in my car in the parking lot, like just regular walking is like, I feel like I can walk again without being short of breath. I can do, the activities that I used to do.

I just feel like it's just completely given me my life back because I don't have those symptoms that I had and I didn't have to go through a really big traumatic surgery. So with saying all that, I just feel almost like I had a new lease on life, especially when I realized that I wasn't short of breath anymore. And I could do the normal things just around the house, that you have to do day to day. So with all that being said, I mean, I still, at this moment, I'm still in awe that it's gone. I still feel like maybe it hasn't sunk in that I didn't have to go through surgery and all that stuff. But I really do feel like it's just been a new lease on life for me.

Host: And Dr. Peck, just before we close, I thought I'd give you the last word. You've just been really proactive, obviously in improving yourself, your skills and obviously finding this technology around AlphaVac, given all of your experience, what is one thing that you know to be true that you'd like to leave with the audience before we close?

Eric Peck, M.D.: Just that I think we're always evolving care here. We're always advancing our knowledge of new technologies and how to provide the best quality care to our patients and minimize the impact on their lives. And I'm just so thankful to Kimberly that she put our trust in us knowing that this was a new procedure. And the team that we had, I think as she spoke to, is just an excellent team and just want patients to know that we're here for them and we're going to do everything we can to get them better and keep them at home with their families.

Host: Well, Dr. Peck and Kimberly, thank you both so much for your time. I truly appreciate it.

Kimberly Marchant: You're welcome. Thank you for, uh, having us.

Eric Peck, M.D.: Thank you.

Host: That was Dr. Eric Peck, Cardiothoracic Surgeon for Dignity Health and his patient Kimberly Marchant. For more information, you can head to Dignityhealth.org/bakersfield/heart. If you found this podcast to be helpful, please share it on your social channels and be sure to check out the entire podcast library for topics of interest to you.

Thanks for checking out this episode of Hello Healthy, a Dignity Health Podcast. Until next time, my name's Prakash. Be well.