Larry Korf talks about his heart surgery and the care he received at Spectrum Health's Fred and Lena Heart Center.
Larry Korf recalls his heart procedure and the care he received at Spectrum Health Fred and Lena Meijer Heart Center in October 2013. (Chris Clark | Spectrum Health Beat)

Not every heart patient has had to be quite as patient as Larry Korf.

He first learned he had a bad heart 17 years ago, when he went to see David Wohns, MD, a cardiologist who now serves as medical director of the Cardiac Catheterization Laboratory at the Spectrum Health Fred and Lena Meijer Heart Center.

Swollen ankles and tightness in his chest took a toll on his stamina and mobility. The cause? One of Korf’s coronary arteries was closing up, reducing the flow of blood to the heart.

Many patients with these symptoms might opt for bypass surgery, but Korf’s arteries weren’t sturdy enough to hold a graft. Surgery was out of the question. So he took his medications, kept a positive attitude and met with Dr. Wohns every year to keep an eye on his heart. His symptoms stayed stable.

About seven years later, things got worse. Korf’s problematic artery was now completely blocked, forming what’s called a chronic total occlusion, or CTO. At the time, CTOs were difficult to open, so for someone like Korf, who was then 56, the only option was to take it easy and wait for something new—a new procedure or technology—to come on the scene.

“Every time I went to Dr. Wohns I’d ask, ‘How’s technology? Is there anything out there we can use?’” Korf said. “And he’d always say, ‘Larry, you stay alive. Technology will catch up.’ And that’s about what happened.”

A revolution in the Cath Lab

David Wohns, MD, poses for a photo.
David Wohns, MD

CTOs are “one of the last frontiers in interventional cardiology,” Dr. Wohns said.

If a blood vessel is even 95 percent of the way blocked, it can be successfully opened with angioplasty or stents, he said. But when those vessels are totally blocked, the success rate plummets to about 20 to 30 percent.

That changed in 2013, when Dr. Wohns and a fellow Spectrum Health Medical Group cardiologist, Kevin Wolschleger, MD, became trained specialists in a new set of nonsurgical technologies and strategies developed to treat CTOs.

Spectrum Health was one of the first health care systems in Michigan to adopt the techniques, and Korf was only the third patient to be treated at Spectrum Health.

Talking over a cup of coffee, Korf laughs when recounting how Dr. Wohns broke the news about the new technology.

“I walked in and he says, ‘I’ve been waiting for you to come. We’ve got a brand-new procedure and I think you’re a good candidate.’ And I says, ‘Really? How many have you done here?’ And he says, ‘I haven’t done any.’”

Hearing that, Korf’s heart may have skipped a beat, but he replied, “You know what, Doc? I’m not getting any better, and I’m not getting any younger. If you think it’ll improve me, let’s go for it.”

A few days later, in October 2013, he went in for a diagnostic catheterization, and the very next week he was back at the Cath Lab for the CTO procedure.

Although he was partly sedated, Korf easily remembers Dr. Wohns’ reaction when the three-hour procedure was over: “He was so geeked. Honest, he was so pumped.”

Here’s how the procedure works: Using new technology recently approved by the FDA and new concepts related to opening blocked arteries, doctors thread a specialized catheter into the artery via the groin and then feed a high-tech guide wire through the catheter. After contrast dye is injected into the artery, X-ray images are taken.

The doctor then spins the device, either driving through the blockage or sneaking around the side of it using a companion device positioned in the vessel wall. This restores the flow of blood through the artery. A stent is inserted to keep the artery open.

Because these procedures have a steep learning curve and a higher risk of complications than routine stenting, only sophisticated, high-volume cardiology programs are able to offer them, Dr. Wohns said. The first few CTO procedures he and Dr. Wolschleger performed, including Korf’s, were supervised by visiting interventional cardiology experts and researchers who developed the technology.

Today Drs. Wohns and Wolschleger and a specially trained Cath Lab team are present for all CTO procedures at the Meijer Heart Center. The team has completed about 90 to date, with a success rate of over 80 percent. They expect to perform about 75 CTO procedures a year on days set aside for this purpose.

Easier than a root canal?

Korf is still amazed at the immediate changes he felt after the procedure.

Larry Korf is shown along Kalamazoo Lake in Saugatuck.
Larry Korf is shown along Kalamazoo Lake in Saugatuck. Korf says he feels “100 percent” since his heart procedure in October 2013. (Chris Clark | Spectrum Health Beat)

“The last five years or so, it was really hard for me to walk,” he said. “We live close to downtown Saugatuck, and it got so bad that I’d take a moped downtown instead of walking.”

The weekend after he had the CTO procedure, he decided to walk downtown to meet friends for coffee.

“And you know what?” he said. “I walked all the way down to the other side of town. Never a pain in my chest. It was amazing. It perked me right up.”

But how can someone with a fully blocked coronary artery survive in the first place?

“The body can wonderfully create new blood flow channels, called collaterals, to give the blood a way through,” Dr. Wohns said. “If the collaterals are rich enough, then it can be OK. We don’t treat closed arteries just because they’re closed; we treat them to help our patients feel better and improve their quality of life.”

Korf credited Dr. Wohns with inspiring him to keep going through the years of waiting. Just retired from a career in the car business, he can now spend more time fishing, boating and traveling. And he wants more people to know what the Cardiac Catheterization Lab can do.

“This was easier than a root canal,” Korf said, and he’s not kidding.

“If someone told me, ‘We’re going to do this heart procedure and we need to do a root canal on that bad tooth—what do you want to do first?’ I’d say, ‘Let’s do this heart deal first.’”