Fourteen months after he had the first heart surgery of its kind in Las Vegas, 53-year-old Dennis Luetkemeyer backpacked for four days through the Maroon Bells wilderness area in Colorado. He traversed a 28-mile loop through four mountain passes, all above 12,000 feet.
What no doubt prepared him for that hike was an earlier 50-mile April trek through the Grand Canyon, just 10 months after Dr. Demetri Mavroidis performed what is known as a Mini-Maze procedure on Luetkemeyer’s heart.
In less than four hours, the cardiac surgeon corrected Luetkemeyer’s atrial fibrillation, a heart rhythm abnormality that increases the risk of stroke seven-fold and is a major contributor to congestive heart failure.
"It’s good to see you looking so well," Mavroidis told Luetkemeyer when they met recently at University Medical Center. "What you do is incredible."
Luetkemeyer thinks what Mavroidis did was incredible.
"Basically, all he did was give me the life I like to live back," he said." And he did it without cracking open my chest."
More than 2 million people in the United States, according to the American Heart Association, suffer from atrial fibrillation, an electrical problem with the heart that causes its upper and lower chambers to beat at mismatched rhythms.
Some people with the condition suffer alarming and exhausting episodes in which the heart races as fast as 200 beats a minute, double the normal resting adult heart rate.
Others, including Luetkemeyer, often don’t know they have the condition until something dramatic happens.
Luetkemeyer, then a safety officer with the Clark County School District, found out after he fainted while gardening in the backyard in 2001.
At the insistence of his wife, Cindy Cardwell, he went to his primary care physician who did some tests and promptly referred him to Dr. William Resh, a cardiologist.
Resh told Luetkemeyer that he not only had atrial fibrillation, he also had a weak, enlarged heart.
"He told me if it got any worse I’d end up as a candidate for a heart transplant," Luetkemeyer recalled. "I was floored."
Resh immediately started Luetkemeyer on the most standard treatment for atrial fibrillation at the time — beta blockers to lower his heart rate, and anticoagulant drugs, which can reduce formation of blood clots that cause strokes.
A number of other options were considered. He had doctors try shocking his heart back into a normal rhythm, which was unsuccessful. He went to UCLA for another procedure, which also failed.
And then last year Cardwell read about the Mini-Maze procedure on the Internet. It was described as a variation on what’s known as the Maze procedure, a complex and risky open heart surgery developed in 1985 that Luetkemeyer never considered.
"The Maze by itself I considered much too risky," he said. "Most of the time it was done as open heart surgery in conjunction with something else, like a valve replacement. I didn’t want them cutting through my breastbone, spreading my ribs, and having to be on a heart lung machine for hours. I figured I’d just have to stay on the drugs."
But the more Luetkemeyer read about the Mini-Maze, the more he wanted to try it. There was only one problem.
No cardiac surgeon in Las Vegas, Resh told Luetkemeyer, was performing the procedure. But Luetkemeyer said Resh believed that Mavroidis could do the work.
Mavroidis, it turned out, had seen it done out of state and was eager to try it. After he practiced the minimally invasive technique on a couple of cadavers, he was sure he could do it without much risk. He had already done the Maze procedure in conjunction with open heart surgery.
The surgeon told Luetkemeyer that he would bring another surgeon to UMC to watch him in the operating room. If the procedure started going bad, that surgeon would take over.
Luetkemeyer, who retired from the school district last year, said it helped him to know Mavroidis "cared enough to bring someone else in."
The procedure, developed by Dr. Randall Wolf at the University of Cincinnati in 2005, began at 7:30 a.m. on June 26, 2008.
"It was a combination of procedures that I felt quite comfortable with," Mavroidis said.
To get to the heart, Mavroidis made three incisions on both sides of the chest, none of which was more than three centimeters long. Through these incisions, he could use surgical instruments, as well as a device to burn off tissue. He would also push through a camera that allowed him to see the heart.
Mavroidis burned lines in Luetkemeyer’s heart, isolating areas where irregular electrical signals started.
No longer would the damaged tissue be able to conduct electrical impulses, meaning the transmission of the abnormal signals had been interrupted so the rest of the chamber could resume beating normally.
Mavroidis also removed the left atrial appendage, a small lip of extra tissue on the left side of the heart where many stroke-causing blood clots form.
Before Luetkemeyer awoke from the anesthesia, Mavroidis told his wife the good news — his heart was beating normally.
Four days after the procedure, Luetkemeyer left the hospital. He said he was sore for about 10 days, but the worst part of the recovery came when his right lung collapsed.
"That was excruciating, but they reinflated the lung at UMC and I was only there for 24 hours," he said.
Word has spread about Mavroidis’ success. He has now done seven more successful Mini-Maze procedures at UMC.
"You feel great when you really help somebody," he said. "This procedure can make a huge difference in people’s lives."
Statistics compiled across the nation on the operation show that the Mini-Maze has an 85 percent success rate.
When Luetkemeyer later went to his cardiologist for tests, results showed that the procedure had also brought his heart to normal size and greatly improved its function.
Day by day, Luetkemeyer said, he built up his endurance so he could get back to mountaineering. For months, he rode a bike or walked long distances. He no longer has the shortness of breath, fatigue and dizziness that once plagued him.
And then came the hiking trips to the Grand Canyon and Colorado.
"I can’t thank Dr. Mavroidis enough," said Luetkemeyer. "I get to really live now."
Contact reporter Paul Harasim at firstname.lastname@example.org or 702-387-2908.