Unique operation ahead for Quinte heart patient, p. 2

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" Perm's recent specialty is best described as high-tech plumbing. "We're really just clever plumbers," says Penn of his team, "and what we're trying to do is open up pipes." To "open pipes" leading to the human heart, Penn uses a device akin to a plumber's roto-rooter. The procedure, medically known as Percutaneous Translu- minal Coronary Rotational Abla- tion, uses a device called the Ro- tablator that acts as a tiny drill to clean plaque from arteries. It is small -- a football shaped bit encrusted with microscopic diamond chips varying in size from 1.25 to 2.5 mm in diameter -- and is driven at speeds up to 190,000 RPM by an air turbine. The drill is connected to a very slender wire which is inserted into an artery in Foley's groin and threaded, along the artery, to his heart. To guide Penn and assistants, a special dye will be injected as the drill moves its way toward his heart. Only 25 such procedures have been done in Canada -- all of them by Penn at London Victoria -- and little more than 1,000 op- erations have been performed in the world since the technique was developed in the United States two years ago. Foley says his "initial anxiety has developed into full-blown fear." But, he says he realizes his options are few. "I know that I either go ahead with this, or..." Foley understands that, with- out forgoing the minimal risks in the procedure -- including "a mortality rate of less than one per cent; chance of a heart attack of four to five per cent and the need for urgent coronary bypass surgery at between one and two per cent," according to a letter Penn sent Foley -- a major heart attack is looming for him. "It's just a matter of time be- fore something serious hap- pens," he says. "I just can't live like that." Foley is an unabashed smoker and enjoys a couple of beers each day with lunch.' "That's going to change. The cigarettes are done, once I get to the hospital." Try and quit, Foley says, when you're at wit's end worry- ing if the next chest pain heralds a major heart attack. Foley is a grandfather -- his daughter Kelly having given birth to a boy last August -- and daughter Kim is expecting an- other grandchild this spring. "That gives you a little more incentive to do the right thing afterward," he says. He'll be awake throughout the procedure, as well. "It's not a lot unlike the an- gioplasty I had six years ago," he said of the procedure that saw a tube fed into Foley's arteries and a tiny balloon, at its tip, inflated to clear blockages in the artery. "But, I'm one of the 25 per cent of people whose arteries re-clog. And they're pretty clogged, all the way along." Apprehensive, nervous and scared, Foley's emotions are barely concealed as he discusses the procedure. But, in his usual, jocular used car salesman banter Foley brightens. "Nothing can happen, I've got 12 cars to get rid of."

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