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Strategies To Mitigate COVID Vascular Complications

· Heart of Innovation


EPISODE 21 Show Notes

With a projected tough winter season with new variants of COVID-19
known BA.4 and BA.5, we wanted to talk about the vascular complications that
can be associated with the virus and strategies around minimizing the risk of
blood clots. In its early days, COVID-19 was classified only a respiratory illness with varying degrees of severity. But as healthcare professionals learned more over time, they started also considering it a vascular disease because of blood clots that led to serious complications, including death. In today's show my-co-host and I are joined by guest co-host Nurse Practitioner Kay Smith and Cardiothoracic Surgeon Dr. David Allie from Lafayette, Louisiana,
as well as a patient, Scott, who almost lost his legs following vascular complications
due to COVID-19. We are talking about the risk of vascular complications associated
with COVID-19 and strategies to minimize arterial/venous thromboembolism (blood
clots), myocardial infarction (damage to the heart muscle caused by lack ofblood supply, which could be the result of a blood clot) complications. During today’s show, some of the strategies to mitigate risk for vascular complications include earlier bloodwork to check cardiovascular biomarkers such as D-dimer and troponin as well as ultrasound imaging of the lungs, heart, and legs upon the early presentation of symptoms, which could signal an earlier need for
aggressive intervention and treatment. Hosts and their guests also talked about
the importance of having a conversation with your physician prior to getting Covid-19 about the appropriate vaccination schedule for you, bloodwork to determine if you have higher risk factors for vascular complications such as with Pre/Diabetes 1/2, Peripheral Artery Disease, Heart Disease, high blood pressure and/or cholesterol, autoimmune conditions, thicker blood due to high ferratin levels and/or iron, etc. They also stressed the importance of having
the conversation with your physician if you get COVID-19 and have high risk factors mentioned above, about if andhow you should mitigate your risk of vascular complications.

A patient withvascular complications from COVID-19, Scott shares his scary story of being on
the verge of losing his legs in the last half of the show. He and his wife ended
up with COVID. His wife was hospitalized due to having complications related to
the virus and COPD. Scott was at home recovering and starting to feel some leg pain,
cramping, and additional coldness to the touch, his left more than his right. Having
high risk factors such as diabetes, high cholesterol, and high blood pressure,
he went to the local hospital about 3:30pm and by 5pm he was in the operating
room. Prior to beingsedated, he distinctly remembers the vascular surgeon saying that his situation was life-threatening and that they would try to save my leg, but that amputation may be necessary. He was given no time to process this, no time to ask for options and no time to consult and discuss with his family. It was scary to go to sleep not knowing whether he would wake up without a leg. Following a bypass to re-route blood flow around artery blockages due to blood clots, and fasciotomy, which is a large incision in the calf to relieve tension and pressure in the leg, he awoke in excruciating pain, but his leg was in tact. After 23 days in the hospital, he was discharged with the vascular surgeon telling him that the battle was over, that it would a long fight ahead to continue to keep his legs.

He was right. By March, the bypass had occluded, and another surgeon hadto clear the graft and restore blood flow using minimally invasive tools and techniques. It was successful.

By September, the graft occluded yet again.

The surgeon admitted him to the hospital and tried aminimally invasive approach to clear the graft again – this time It wasn’t successful. He planned to bring Scott back in two weeks after some vein mapping to find a vein in his other leg or arm to use to replace the other bypass graft that had blocked. Scott had lost his patience. His cousin Carol suggested an
office-based lab nearby that she had found through peripheral artery disease advocacy organization The Way To My Heart, where vascular specialists had saved her leg using advanced minimally invasive tools and techniques. Doctors there were able to successfully bypass the bypass and clear the native arteries his other physicians couldn’t clear with their methods in a minimally invasive way. He exclaims, “I walked out immediately following the procedure.” He’s been walking without pain ever since and drives home the importance of always getting a second opinion when you can before any procedure. He says, “You have options! This is YOUR life, your limbs and ultimately, your decision.” 

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