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Sentara first in region to remove blood clots without open surgery



When large blood clots are discovered inside the right atrial chamber of the heart, and clot-dissolving medication fails, the clot can come loose and turn into a life-threatening pulmonary embolism or stroke. Venous thromboembolisms (VTE), blood clots which originate in a vein, are the third leading cause of cardiovascular death after heart attack and stroke. VTEs affect 600,000 to 1 million Americans every year. Previously, removal of certain clots in the heart or abdomen required invasive open surgery. That is, until now.


At Sentara Norfolk General Hospital, a fellowship-trained vascular surgeon offers a minimally-invasive alternative to open-heart surgery—a catheter-based device and X-ray, ultrasound guidance to vacuum the targeted clot out of the heart.


“This specialized technology allows us to remove these life-threatening clots with minimal impact to the patient,” said David Dexter, M.D., FACS, Sentara Vascular Specialists, one of four in Virginia who use this technology and the only in Southeast Virginia. “Generally, this procedure takes less time and patients could leave the hospital in as soon as two days.” 


Performed in a hybrid operating room, the vascular surgeon works with a multidisciplinary team comprised of a cardiothoracic surgeon and cardiologist. The vascular surgeon inserts thin tubes into two major veins in the body through the neck or groin area. Under X-ray and ultrasound guidance, the tubes are advanced toward the affected area. Each tube is equipped with an expandable, balloon-shaped funnel tip which is attached to the circuit portion of the clot vacuum. This creates a bypass which filters blood outside of the body during the removal, or vacuuming, of the clot. During surgery, a reinfusion tube sends filtered blood back into the body, minimizing blood loss.


Dr. Dexter has successfully removed clots from the heart’s right atrium, inferior vena cava and superior vena cava since 2014. In 2016, he was the first in the country to use this particular technology to remove a blood clot in a pediatric patient’s right atrium.


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