Revisiting a heart
When Dr. Hemraj Makwana told Suzette Creppel Green she had a hole in her heart, she thought, “Oh my goodness, not another one.”
Green was the first person to undergo a revolutionary noninvasive procedure to fix a hole in her heart when she was 17-years-old. Interventional cardiologist Dr. Terry King helped develop a way to close a hole in the heart without open-heart surgery, and he performed the procedure on Green at Ochsner Hospital in New Orleans on April 8, 1975.
Forty-four years later, on May 7 of this year, Makwana performed the same procedure on Green at Baptist Memorial Hospital-Golden Triangle in Columbus. It was the first surgery of its kind performed at Baptist.
“I was nervous, but I wasn’t quite as nervous (as last time) because I believed in my doctors,” Green said.
She made sure Makwana had King’s contact information so they could discuss the best treatment for her.
“I have him on speed dial,” she said. “Dr. King calls me once a year to see how I’m doing and all.”
A pioneering procedure
Green grew up in Crown Point, Louisiana, south of New Orleans, and has lived in Caledonia since 2009, when she and her husband moved there to be closer to his family. She has four children, seven grandchildren and an 8-month-old great-granddaughter.
Her first child was born when she was 16, and “that’s how they really found out how bad my heart was,” even though it had sent her to the hospital periodically since early childhood.
At the time, open-heart surgery was the only known remedy for a hole in the heart, but King had been developing an idea for an alternative procedure since the late 1960s when he was a cardiology fellow at Duke University.
He solidified the idea when he was stationed at Wilford Hall Medical Center at Lackland Air Force Base in San Antonio, Texas, and was asked to remove a loose catheter from a child’s heart through the leg. He was the fifth doctor to attempt the procedure, and the first to succeed instead of resorting to surgery, he said.
“It confirmed my thoughts that if you can make a hole with catheters and you can pull things out of patients’ hearts with catheters, why can’t you close the hole (in the heart)?” King said.
The next question was what could be small enough to enter the body through a catheter but big enough to close a hole, and the answer came to him at 4 a.m. one morning: an umbrella.
King worked with cardiac surgeon Dr. Noah Mills to create the umbrella-like device made of surgical stainless steel and a form of polyester. The five-foot catheter is inserted from the leg to the heart and attached to either side of the hole so it can snap closed and, over the next several months, grow into the flesh of the heart.
King and Mills perfected the procedure in experimental models at Ochsner until they were comfortable performing it on a human.
That human was Suzette Creppel, not yet Green, and the procedure was done in seven minutes, King said.
Green didn’t know she was the first person to undergo the Mills-King procedure, as it is called in medical textbooks, and the media storm that hit when she was released from the hospital was terrifying, she said. After the initial press conference in a room packed with reporters, she received phone calls for the next few months from several news outlets, some from other countries.
“I just had people from all over calling for interviews,” Green said. “I think I was more excited that they had fixed the heart and I didn’t have to go through open-heart surgery.”
King’s share of attention for the procedure that created the field of interventional cardiology continues today. He has traveled to a variety of countries including Poland, Germany, Argentina and Honduras as well as all over the U.S. to talk about his work, he said.
More than one million people have gone through the procedure since 1975, and it has been adapted into 33 versions worldwide, he said.
Local availability
Makwana had done the Mills-King procedure hundreds of times before, but introducing it to the Golden Triangle and performing it on the first person to receive it made him feel “very privileged,” he said.
He came to Columbus from Lima, Ohio in September 2018 partly because he saw a local need for a doctor who performs structural heart procedures.
“We don’t have any other specialists in town. I’m the only one to provide this care for the community,” Makwana said.
Green’s second Mills-King was also the first structural heart procedure performed in Baptist’s new Hybrid Operating Room, which opened in April. The $1.3 million, 1,000-square-foot room includes a variety of technology meant to help surgeons perform faster, more accurate and less invasive procedures.
People in the Golden Triangle who needed the Mills-King procedure done had to drive to Tupelo or Birmingham before Green’s procedure in May, Makwana said. The procedure requires a patient to stay in the hospital overnight, so staying as close to home as possible is both more convenient and keeps patients close to their support systems.
“You can just do it here and go home the next morning,” Makwana said. “A lot of people (might) feel uncomfortable going to a big city. Plus their local doctor’s not there, and their family is here.”
The second procedure worked as it was supposed to, and Green said she is no longer frequently exhausted and short of breath.
“I was a little scared because I didn’t know how it was going to work with the first umbrella, doing the second one, but I was so glad after I had it done because it came out as great as the other one,” she said.
Story by Tess Vrbin
Opening photo by Jennifer Mosbrucker
Historic photo courtesy of Suzette Creppel Green
Surgery room photo by Amanda Lien
