Miracle at UNC
Medical Center
Tlitk lioarl operation now offering*
hope of a bright, new future for
thousands.
By CLAY WILLIAMS
Public Information Officer. N. C. State Board of Health
An amazing new heart operation
now being performed at the UNC
Medical Center at Chapel Hill is mi¬
raculously revitalizing people who
have been totally crippled mentally and
physically by heart disease.
A team of heart surgeons, headed
by Dr. Ben Wilcox, a drawling
ЗУ
year-old native of Charlotte, has been
performing revascularization (bypass
graft) operations on the human heart
since last December. They have
achieved remarkable success.
Angina pectoris. a condition
marked by spasmodic attacks of in¬
tense suffocative pain, occurs when the
blood supply to heart muscle is dimin¬
ished. Dr. Wilcox pointed out that the
exciting thing about the bypass graft
operation is that it has enabled angina
sufferers taking up to 40 nitroglycerin
tablets per day to control heart pain
to return to a full schedule of work —
completely free of pain.
Over 500.000 people die of coro¬
nary heart disease in America each
year. Dr. Louis Wilson, a 34-year-old
member of the UNC surgical team,
said that current experience suggests
that more than 70-80 percent of all
patients disabled with coronary heart
disease can be operated on success¬
fully. "Assuming the procedure’s cur¬
rent success is borne out over the next
few years, great demand will be placed
upon surgical teams throughout the
country." he said. Present indications
arc that the operation carries a risk of
from three to fifteen percent, depend¬
ing upon whether one or all three coro¬
nary artery branches arc involved.
The operation is made possible by
the angiogram, a fluoroscopic diagnos¬
tic technique that defines the exact lo¬
cation of occluded vessels in the heart.
The angiographic technique was given
a boost as far back as 1929 when Dr.
Werner Forssman passed a catheter
into his own heart via a superficial
vein in the arm during his lunch break.
In order to prove the validity of the
procedure, he then went to X-ray and
had the location of the catheter veri¬
fied in his heart. Dr. Forssman along
with three other doctors were awarded
the Nobel Prize for their achievements
in the area of heart catheterization.
Locating the Occlusion
Today the technique consists of in¬
serting a catheter with a curved tip
into either the arm or leg artery to a
point at the base of the aorta — the
main vessel carrying blood from the
heart. The catheter is then passed into
the pumping chamber (left ventricle).
C.;
Dr. Ben Wilco»,
о
nolivc of Chorlotlc, hcodt the
leom of heort surgeont performing the rcroscu-
lorizolion bypats grofl operation.
A small amount of contrast dye is in¬
jected in order to locate the catheter
lip. Once the position of the catheter
has been insured, dye in a large enough
dose to outline the area is injected un¬
der pressure. Simultaneously, movies
are taken of the procedure. This al¬
lows surgeons to study trouble spots to
the extent that they choose. Walls of
the pumping chamber arc studied for
weak areas that might signal a develop¬
ing ventricular aneurysm — a bal¬
looning out of the pumping chamber
wall that has been weakened due to a
heart attack. The condition is marked
by an abnormally large and insufficient
chamber, which cuts down on the ef¬
ficiency of the heart muscle to pump.
Next, the catheter is passed through
the trunk of the coronary artery to a
point where the vessel separates into
three branches on the surface of the
heart. The purpose of the coronary
artery is to supply heart muscle with
a nourishing supply of blood. Fxtreme
care is taken not to obstruct the flow
of blood with the catheter tip. A small
amount of dye is injected in order to
outline the arteries for evidence of any
life-threatening blocks.
Before the Operation
The days, sometimes weeks, of col¬
lecting diagnostic evidence arc now
completed and the decision is made
whether or not to operate. For the pa¬
tient. who lives between the hovering
shadows of death from heart attack or
a stroke, and perhaps many additional
years of life that the operation could
give, it is time for a decision. For
some timidity prevails and they take
their chances. Most, however, elect to
have the operation. "It is rewarding to
see positive results in a patient." Dr.
Wilcox said, "to sec him walk across
the room without becoming exhausted
to see him return to his family and
community as a functioning indivi¬
dual."
At 6:00 a. m. on the day of the op¬
eration the operating room, chocked
full of exotic equipment and one of
the most modern in the country, is a
beehive of activity. Efficiency and co¬
ordinated activity is the order of the
day and the smartly drilled supportive
staff exhibit their qualifications in
every department. The patient arrives
in the operating room at 6:30.
Dr. Wilcox arrives about 7:30. The
lanky, unassuming surgeon, who had
spent a good portion of the night re¬
viewing film and X-rays of the patient,
checks charts and confers with those
THE STATE. NOVEMBER 1, 1971
17
