For Robert Bennett, of Montello, 2021 brought a slew of new medical problems — from dangerously high cholesterol to unexplained vomiting.
Physicians at another health system diagnosed severe blockages in his coronary arteries — the critical vessels that supply blood to the heart. Robert needed an intervention to restore blood flow, so he was quickly scheduled for a stent procedure.
“When I woke up after the procedure, the doctor came in to talk to me,” Robert said. “He said, ‘Well, we didn’t do any stents.’ I thought that sounded good because it sounded like I didn’t need them.”
Then the doctor explained that twists and turns in Robert’s arteries might make stenting or bypass surgery too risky.
“He took out a piece of paper and drew my blood vessels — it was kind of a spaghetti mess,” Robert said. “Then he said he would put me on drug therapy and see how it went.”
Less than three months later, Robert’s wife, Julie, had to rush him to a hospital near Montello. He was suffering from respiratory failure, kidney failure and cardiogenic shock.
“I actually coded in the emergency department,” Robert said. “My heart stopped for six and a half minutes before they brought me back.”
Robert was soon on a helicopter bound for Froedtert Hospital, the academic medical center of the Froedtert & the Medical College of Wisconsin health network.
“It was a blessing in disguise because if I hadn’t gone to Froedtert Hospital, I don’t think I would be alive now,” he said.
Equipped to Help Treat Complex Artery Blockages
At Froedtert Hospital, Robert spent a week in the ICU. Once stabilized, he was visited by Iyad Azzam, MD, interventional cardiologist and MCW faculty member.
“Dr. Azzam introduced himself and offered to help me understand the complexity of my blockages and anatomy, as well as the technical challenges and the high risk of a stenting procedure,” Robert said.
Dr. Azzam told Robert that spaghetti-like arteries were not the only issue. He also had multiple coronary blockages, including a 100% occlusion of his left anterior descending artery, also known as “the widowmaker” because heart attacks that occur when that artery is blocked are severe and can be fatal. And, in addition to being diabetic, he now had kidney disease.
“Dr. Azzam said I was considered ‘high, high, high risk’ for any intervention — three highs,” Robert said. “But then he said, ‘I think I can help you.’”
Dr. Azzam is the director of the Complex and High-Risk Coronary Intervention Program (CHIP) at Froedtert Hospital. He specializes in treating challenging, highly complex and totally blocked arteries.
According to Dr. Azzam, this includes patients with multiple blockages in key arteries. It can also include patients, like Robert, with “curly” arteries or an artery that is blocked completely, known as a chronic total occlusion or CTO.
Given the complexity of Robert’s case, Dr. Azzam designed a staged care plan. Blockages were treated during three separate procedures in September, November and December 2021.
Doctors in the CHIP program have access to a full range of advanced, minimally invasive technologies for opening coronary blockages. For Robert, the toolbox included a shockwave balloon, which uses sonic pressure to break up blockages; an intra-aortic balloon pump to maintain blood flow during complex procedures; and a specialized catheter device to open the toughest arterial calcifications.
“The right side of Robert’s heart was heavily calcified, so we used a device similar to a roto-rooter to create cracks in the calcium so we could expand a stent in the artery and restore the blood flow he needed,” Dr. Azzam said.
Next-Level Care from Expert Coronary Care Team
Today, Robert said he feels 20 years younger. His heart no longer troubles him, and his kidney function has improved dramatically. He is no longer on hemodialysis. Robert has nothing but gratitude for his team at Froedtert Hospital.
“The nurses were unbelievable — just so professional — and everyone really cared,” he said. “Dr. Azzam is like Superman. He probably prolonged my life by 15 years or even longer.”
Dr. Azzam ascribes the success of the CHIP program to its team-based approach and adherence to evidence-based medicine.
“We welcome patients from everywhere and treat a high number of high-risk heart patients,” Dr. Azzam said. “Our patient outcomes with chronic total occlusions are among the best in the country.”
After treatment, patients return to their local doctors for ongoing care.
Know the Options for Coronary Artery Disease
What should a person do if told their heart blockage is untreatable? Dr. Azzam said it is important to know the options.
“If you are on medications for coronary disease but still have significant symptoms — like chest pain, chest discomfort or even shortness of breath — don’t settle for it,” he said. “With the expertise and technology we have in the Froedtert & MCW health network, we can help many patients after other therapies fall short.”
The Froedtert & MCW Complex and High-Risk Coronary Intervention Program offers leading-edge care for complex conditions. To learn more, visit froedtert.com/CHIP.
