George Toler is on the table at the catheterization lab at Rex Hospital.
He's having the procedure to place a stent in a blocked heart artery, accessed through the wrist. And he couldn't be in better hands for this procedure than with cardiologist Dr. Tift Mann.
“He probably has done more radial cardiac catheterizations than anybody in this country,” said Dr. William Newman, a cardiologist who works with Mann at Wake Heart and Vascular.
Mann brought the transradial approach to Wake County and trained other cardiologists in the procedure. The standard procedure is done though the femoral artery near the groin, but there are clear advantages to the wrist approach.
“The advantage of the procedure is that bleeding with the procedure is so much less,” Mann said.
The entry point is smaller and heals quicker, and the patient can return to normal activity faster.
Still, the transradial approach represents only 15 to 20 percent of cases in the United States. In Europe, 60 to 70 percent of catheterization patients undergo transradial, Mann said.
Mann's career started at a time when heart attack patients had only two options: medication or open heart surgery. Now the time from a 911 call to the start of treatment in a cath lab can less than 90 minutes.
Heart attack deaths have dropped from about 20 percent to 2 or 3 percent.
After about 34 years and 17,000 procedures – including 30 just this week – Mann is hanging up his scrubs.
“Well, I had my 70th birthday in October, so it was time to move on,” he said.
Colleagues gathered to witness the event and offer their best wishes. But few expect him to stay out of the medical setting.
“I don't think any of us wake up one day and turn the light switch off and we're done,” Newman said. “And somehow, I don't believe that he is finished.”