Hearts Draw Surgeons Together

In an occasional exchange of calls or e-mails two heart surgeons who met when they were in the same residency program would try to coax each other to make a move.

Robert Fietsam, M.D., was in North Carolina. Nicholas Augelli, M.D., was in Davenport with Genesis Medical Center.

“A couple times I tried to get Nick to come to North Carolina but he was happy where he was,’’ Dr. Fietsam explained. “Then a few months ago I heard from Nick and he said, ‘we have an opening here, why don’t you look at coming to Davenport?’’’

The timing was right for Dr. Fietsam to make such a move and recently he  joined Augelli in the Genesis heart surgery program that recently received the highest rating available – three stars – from the Society of Thoracic Surgeons. The rating places the Genesis program in the top 15 percent of hospitals submitting data.

“Nick and I have talked about practicing together for many years. We always thought we would work very well together and now we’re getting that chance,’’ Dr. Fietsam said. “It was like it was destined to happen, it just took time.

“Everything just fell into place. My situation in North Carolina was changing, the opportunity to come here was open, we were able to sell our house and buy one here. Everything worked out.’’

Dr. Fietsam comes to Genesis from Cape Fear Valley Health System in Fayetteville, N.C.  The Cape Fear Valley Health System, facing difficult financial issues, began to discuss an affiliation with Cleveland Clinic to provide cardiac surgery services and Dr. Fietsam wasn’t sure what that would mean to his practice.

“I had an independent practice. We didn’t know what the affiliation was going to mean. My wife, Jill, and I have six children from 13-year-old twins to a 4-year-old.  You don’t like to feel insecure about your future when you have six children,’’ Dr. Fietsam said, chuckling.

Dr. Fietsam decided to join Dr. Augelli at Genesis earlier this year. Cape Fear Valley Health System announced the affiliation with Cleveland Clinic on June 28.

“It’s kind of amazing how well things worked out,’’ Dr. Fietsam said. “I’m a strong believer that if you allow God’s will to play out, good things will happen. They did in this case.’’

In the Quad Cities, Dr. Fietsam will only be a few hours away from his parents and eight siblings in Michigan instead of 16 hours away as he was in North Carolina.

Complementary Skills
Partly because they know each other and were trained in the same residency program, Dr. Fietsam said his skills and experiences will fit well with those of Dr. Augelli.

“Dr. Fietsam’s enthusiasm and talent have already been a great addition to the Genesis heart surgery program,’’ said Craig Sommers, Executive Director for Genesis Heart Institute.  “Genesis is committed to maintaining a high quality cardiac surgery program and both Drs. Fietsam and Augelli are instrumental in ensuring high quality care is provided to our patients.’’

A large percentage of the coronary artery bypass surgeries Dr. Fietsam does are off-pump bypass, or “beating heart’’ bypass surgeries without the use of a heart-lung machine.  While he has done off-pump bypass, a large percentage of Dr. Augelli’s heart surgeries involve repairing heart valves, which requires the use of a heart-lung machine.

“I think we will complement each other very well that way and the patients in the region will benefit,’’ Dr. Fietsam said. “Depending on the needs of the patient and what is best for the patient, both options will be available from surgeons with experience in both options.’’

There has been research indicating that patients who are at increased risk for complications from cardiopulmonary bypass, such as patients who have suffered a stroke, may be at less risk of complications from “beating heart’’ bypass surgery.

Dr. Fietsam also has a special interest in surgeries to correct patent ductus arteriosus, or PDA, in newborns.  Patent ductus arteriosus (PDA) is a congenital heart defect that can progress to congestive heart failure.  Babies born at Genesis with the defect are now transported to University of Iowa Children’s Hospital for surgery.

Experience With Tiny Patients
Transport may not be necessary soon. Dr. Fietsam has done more than 100 of the procedures in the last 10 years.

“This particular surgery is very personal to me. Our twins, now 13, were 1 pounds, 13 ounces and 1 pound 131/2 ounces at birth and a PDA is not uncommon in premature babies,’’ Dr. Fietsam said. “Typically the babies with the PDA defect are pretty tiny. The smallest baby I ever performed the surgery on was 1 pound, 1 ounce and was born at 23 weeks (17 weeks early).

“I’m looking forward to working with Dr. Pyevich and Dr. Zeidan to see if we can prevent having to transport babies to have this procedure in Iowa City.  The collaboration we have with the University of Iowa Children’s Hospital could mean that babies with PDA could stay here and have the surgery, which is much easier and less stressful for families.’’

Vickie Pyevich, M.D., is a pediatric cardiologist who is affiliated with the University of Iowa, but practices from an office at the Genesis Heart Institute. Zahi Zeidan, M.D., is the medical director of the Genesis Neonatal Intensive Care Unit and is also affiliated with the University of Iowa.

Doctors often suggest exercise for patients, particularly heart patients. Dr. Fietsam follows doctor’s orders to the extreme when it comes to exercise. He is a distance runner who has competed in the Boston Marathon twice, the Chicago Marathon, the Marine Corps marathon and recently, ran his first Quad-City Times Bix 7.

“For a long time my kids would ask how I did and I’d say I was first in my division. They’d say, ‘what division is that?’ and I’d say, ‘cardiovascular surgeons with six kids.’"

"It took them a while but they figured out I was probably last in my division, too."