AUSTIN (KXAN) — The vertical scar on Anastasia Allen’s chest comes with more history than the 38-year-old would hope. Ten years ago, a blood infection led to her losing a leg and one of her heart valves being replaced.
“Every movement first, basically, it’s like, if you could have stopped breathing, I would have gladly done that,” Allen said about the pain of the surgery.
For weeks, every movement, every giggle, every sneeze felt like torture. “The knowledge that you were about to sneeze is like, it’s something you have to prepare yourself for.”
Ten years later, that valve needed a replacement. This time, Allen, a cardiac nurse, got a different type of open-heart surgery. This one was a lot colder.
“I can’t believe that it’s not being done like for every surgery, you know, it just makes such a difference,” she said.
Her surgeon, Dr. Eric Hoenicke, with Cardiothoracic and Vascular Surgeons (CTVS), turned to cryoanalgesia to stun and freeze the bundles of nerves surrounding her heart.
Cold cold heart
“There’s a number of nerves that go to the sternum that are responsible for pain sensation, and it’s kind of like giving a lidocaine injection to those nerves,” Dr. Hoenicke said.
Dr. Hoenicke uses a tool called AtriCure. The tool is shaped like a gun, with a long flexible hose running from the end. At the end of this hose, a metal ball. Liquid nitrogen flows through the tool, dropping the temperature of the ball to negative 70 degrees Celsius.
“With the use of this cryo nerve block, we can decrease the use of narcotics and get patients home comfortably and sometimes even faster,” Dr. Hoenicke said.
The cold stuns the nerves, which wrap around the ribs, for weeks. They slowly regain sensation over time.
“Some patients say, when I ask them how their pain is, they say they never had any, which is really unusual for somebody who’s had their chest open up like this,” Dr. Hoenicke said.
Around two million open-heart surgeries are performed each year, according to the National Institutes of Health. Dr. Hoenicke says he’s one of the few heart surgeons who use this technique in the county.
Freeze the pain away
The technique, cryoanalgesia, is used for other chest surgeries. These include cardiothoracic surgeries and pectus excavatum repairs, where an inverted sternum and its surrounding ribs are cracked and readjusted to lift pressure off the heart and lungs.
Typically, recovery from open-heart surgery takes weeks, if not months. The ribs are cracked open along the sternum.
“Usually, the people that I take care of, I’ll ask them, ‘How’s your pain doing WITH the standard surgery?’ And they’ll say, ‘Oh, it’s only four or five,” Allen said.
Patients rely on narcotics to make it through the pain.
“Dr. Hoenicke says they stand like toy soldiers. You know, it’s like they do as little movement as possible,” Allen said. She said she was the same way after her first surgery. This time, with all the nerves frozen, she moves around freely.
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