Cardiac & Vascular
Research Center
of Northern Michigan

560 W. Mitchell Street
Suite 480
Petoskey MI,49770

(231) 487-9185

Local doctor called to Montreal to help 12-year-old girl

BY BETHANY ROOT NEWS-REVIEW STAFF WRITER
Friday, June 23, 2006 11:36 AM EDT

As an internationally recognized expert on cardiac catheterization, local interventional cardiologist Dr. Louis A. Cannon has touched many hearts - literally.
He's operated on relatives of foreign dignitaries and patients from all over the world. But on Friday, for the first time, he was scheduled to perform surgery on the heart of a child.
“I've done these (operations) in Singapore, I've done them in Japan,” said Cannon. “But never on a 12-year-old girl.”

Because of his skills, Cannon was sought by physicians at the Montreal Heart Institute in Canada, where the girl with Kawasaki's disease was being treated. Traditional techniques had failed, and her physicians asked Cannon, program director for the Northern Michigan Hospital Heart and Vascular Institute, to fly in to perform an experimental procedure he has been studying for almost 10 years.

When chronic total occlusions (CTOs) occur in the arteries of the heart, it means that the pathway for blood has been blocked, generally by a mass consisting of hard, calcified caps on either end and a soft inner tissue. Jennifer LaLonde, director of research at the NMH institute, compares the CTO to a hard-boiled egg.
“If you don't get blood to the muscle, it doesn't have oxygen,” she added, looking on as Cannon performed a procedure on a patient in the hospital's cath lab last week.

The traditional way of breaking up the CTO has been to flood the artery with saline (for visual contrast) so the pathway can be seen, insert a wire with a small collapsed balloon attached into the artery, inflate the balloon and thus open the pathway.  But sometimes the wire cannot penetrate the calcified caps of the occlusion. This was the case with the 12-year-old girl in Montreal. The CTO was blocking the left main artery of her heart, which meant that two-thirds of her heart wasn't receiving the oxygen it needed.  In the past, the only other option for the girl would have been to receive bypass surgery.  But thanks to new technology, there is now new hope. An experimental device called the FlowCardia CROSSER, currently undergoing clinical trials overseen by the FDA, uses ultrasound technology to “drill” through the calcified caps. When it touches soft tissue, it automatically stops. But the procedure is especially tricky because without being able to flood the pathway with contrast past the blockage, there is no way to know what lays beyond it.

The first prototype of the device was introduced in 1998, then it was further developed to make it easier to use. The newest model is easier to “steer” and isn't as big and bulky, LaLonde said.  But even after the improvements, the device requires a sure hand.
That's where Dr. Cannon comes in. He has been associated with FlowCardia's research since the beginning. He's had more experience using it than anybody, and according to LaLonde, he has “very talented hands.”  “He makes it look easy,” she said, watching him maneuver a wire through the pathways of a patient's heart. “That's why he's sought out. He's got an amazing feel for it. But more importantly, he has the foresight to know how to get himself in and out (of the artery).”

So when the physicians in Montreal needed an expert, they called Cannon.  Moving the patient to the U.S. would have taken away her support system, LaLonde explained. Plus, her family spoke only French. So the best option was for Cannon to come to her.
So Cannon and his team spent 12 days arranging the visit. International lines, the patient's status as a minor, and other regulations made it difficult to work out. But he finished the paperwork, received a temporary license through Quebec University and finally made it to her bedside.

Cannon wasn't always so motivated. He graduated from high school with a 1.8 grade point average, went to college to participate in sports and went to medical school at Wright State University because he didn't particularly want to sell furniture with his dad. Now he is board certified in internal medicine, emergency medicine, cardiology and interventional cardiology.
Cannon moved to Northern Michigan two years ago from Saginaw, where he was the president of the Michigan Cardiovascular Institute.

“I enjoy combining what I really enjoy - being able to help people- and utilizing ever-safer and more efficient modalities,” said Cannon, who is particularly interested in medical technology and has published hundreds of papers and written textbook chapters on the topic.  Still, sitting in his office last week after completing a successful procedure, Cannon admitted he felt a little nervous about the upcoming Montreal trip. He was scheduled to leave for Canada that night, to operate on the girl the next morning.  “Obviously there's a little bit of trepidation,” he said. “But with a little help from above, sure hands, and fleetness of mind, I hope it works out.”  “But it has kept me up nights a couple times,” he added.

But the story has a happy ending. His tiny patient, a petite blonde accompanied by a white teddy bear, was wheeled into surgery, and Cannon and his team discovered a large amount of calcification in her heart, plus a huge aneurysm, he said.  “When we weren't able to open it up in 10 or 15 minutes, when I saw what we were dealing with for the first time, I could see why they wanted me there,” he said a few days after the trip. “It was really going to be a bear. No one had done one (of these procedures) on someone that age, and that small or with an aneurysm before. There were so many unknowns that everyone was going into it with a little bit of fear.”  After about 15 minutes of using the ultrasound device, Cannon got the wire through the blockage, and everyone in the room breathed a sigh of relief.
“It feels so great, to think I made huge impact over the course of her life,” he said.

Cannon didn't just save a girl's life - he did it for free. He may strive to make other peoples' hearts better, but he has shown that his heart doesn't need any work.