When Jason Knutson, DO, suffered a life-threatening aortic aneurysm rupture, he needed expert vascular surgery by a highly trained subspecialist within a short window of time if he was going to survive. Because the right expertise was available through the vascular team at Avera Heart Hospital, he’s here today.
In the past, a procedure like this would have meant an open surgery and weeks of recovery. But even though he was on the brink between life and death, Knutson’s procedure to repair the rupture with a minimally invasive catheter and balloon to place the graft.
“I had about a 2% chance of survival. A string of little miracles had to happen to make one big miracle happen. After I was stabilized in the Avera McKennan Emergency Department, Dr. Tommy Reynolds and the vascular team at Avera Heart Hospital provided the precise interventions needed to save my life,” said Knutson, who is a family practice physician with Avera.
While Knutson’s case was an extreme emergency, all vascular patients want to be able to enjoy a good quality of life, do the type of exercise they enjoy and spend time with their family. And it’s this team’s goal to get them back to doing what they love.
When most people think of the Avera Heart Hospital and the specialists at North Central Heart, heart is the obvious thing to think about. But a team of specialized vascular experts work on the 60,000-mile network of arteries and vessels outside of the heart and brain.
Experienced Vascular Team in Sioux Falls
The vascular team at North Central Heart has been established in Sioux Falls nearly 30 years. They include J. Michael Bacharach, MD, FACC, FSCAI, MPH; Tommy R. Reynolds, MD, FACS; Dustin Weiss, MD, FACS; a board-certified vascular surgeon who joined the team nine years ago; and Mark Fleming, MD, FACS.
Mark Fleming, MD
The team continues to grow to meet patient needs. Fleming had rotated at the Avera Heart Hospital as a fellow at Mayo Rochester, and 12 years later was excited for the opportunity to join the team. “I knew the fantastic structure and depth of expertise at the Avera Heart Hospital and North Central Heart.”
“We have a superb team at the Avera Heart Hospital in general but also specifically in vascular care,” said Bacharach. “We complete complex cases, and we have been as leading-edge as any site in the nation.”
These physicians provide the full range of vascular care including carotid artery stenting, abdominal aortic aneurysm fixes, transcatheter aortic valve replacement (TAVR) for congestive heart failure, treatment of peripheral arterial disease, and other leg and extremity stenting, including for wound care and limb preservation.
“Vascular surgery is one surgical specialty where you can often develop a long-term relationship with patients due to the nature of the disease. That’s the main reason I chose it,” Fleming said. “And, vascular surgery is very advanced in techniques and technology.”
The vascular team has done a number of “firsts” for the city and region, including endograph technology and aortic endography, the first carotid stent and the first thrombolytic therapy. Avera Heart Hospital staff were first in the world to perform a Pounce™ thrombectomy.
Growth Through Research
With involvement in research, Avera Heart Hospital’s has earned attention from medical device makers who want their help in clinical tests of new equipment.
“We’re on the forefront of contributions to vascular care,” said Robin Farley, RN, Avera Heart Hospital Research Team Leader and valve coordinator. While not all patients fit the guidelines for clinical trials, Farley said her team is proud to offer additional options for patients.
“Some devices were born in our facility, and now they’re proven parts of our treatment,” said Mick Gibbs, Avera Heart Hospital President and CEO. “Our vascular surgery team embodies the Avera mission and our work.”
Health Care as an Entrepreneurial Effort
Bacharach and Reynolds were the vascular specialists on the North Central Heart team when the Avera Heart Hospital of South Dakota was launched in 2000.
Combining experts at one setting to serve patients has always been the driving idea behind the work of North Central Heart, a division of the Avera Heart Hospital. “Having all the experts in one room – that’s the best way to serve the patient,” Bacharach said. “We realized distilling that expertise into a specific part of health care could have success.” They’ve partnered through the years with Avera Heart Hospital administrators and other physicians to ensure the latest technology and expertise is offered, right here in Sioux Falls.
“We keep innovating, but we always ensure we’re using whatever procedure is best for the patient,” Weiss said. “We’re able to provide full-spectrum care and help a wide range of patients.”
Improved medical devices, such as angioplasty balloons and stents that are medically treated, are newer tools in the specialty. Carotid artery stents are another; they can be a lifesaving defense against stroke.
Evolving Vascular Expertise
As the vascular specialty and new technology have evolved across the decades, so has the expertise of this team. And they’ve been committed to sharing that expertise through education, including vascular fellowships.
“A significant change in vascular care is minimally invasive endovascular approaches to treatment,” said Reynolds. “We can do a lot more now with closed procedures that let us avoid complications.”
Open vascular procedures involve a large incision and surgical opening. Today, the surgeons perform an open procedure when needed, but they also turn to minimally invasive options whenever possible.
“We have hybrid procedure rooms for endovascular or open procedures,” Weiss said.
The Avera Heart Hospital care model succeeds because of the follow-up work and a strong team that includes many beyond the OR. “We guide the patient through recovery as a team,” Weiss said.
“Medical professionals who join us see things like we do – that we’re all merely here to help patients,” Reynolds said. “Those who came before us set the bar high. We’re working hard to honor their work.”
Learn about vascular services at Avera.
Pictured, top right, are Drs. Dustin Weiss, Tommy Reynolds and J. Michael Bacharach.
