Heart Center Offers Advanced
Diagnostic and Surgical Care
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Dr. Patrick Coleman is watching what looks like a television. But this is no daytime soap opera playing on the small black and white screen he peers intently at just a few feet in front of him. Rather, he and his specially trained team of nurses and technicians are searching for arterial blockages in a patient who has been referred to Sutter Medical Center of Santa Rosa's new state-of-the-art Cardiac Catheterization Laboratory.
The lab itself is part of a larger "Heart Center" that has been years in the planning. It opened on August 14, 2001. The center includes, for the first time ever at Sutter Santa Rosa, open heart surgery capabilities in a suite dedicated strictly for that purpose.
The completely self-contained Cath Lab is located in a newly constructed wing built onto the existing hospital. It includes equipment, staff and support services that enable patients to receive a variety of cardiac catheterization procedures such as Coleman is providing this morning.
The Angiography "Gold Standard"
With the assistance of a new, technologically advanced cardiac imaging system known as the Philips Integris H5000, Coleman is obtaining precise images of the coronary artery blockages that have left this patient in a weakened condition, unable to undertake even the most basic activities without becoming exhausted. The procedure, known as a coronary angiograph, will tell Coleman exactly where and to what degree the patient's arteries are blocked. Then he will better know whether she can benefit from other catheterization procedures to clear the artery—or whether she might be a candidate for open heart surgery performed by his colleague, veteran cardiac surgeon Keith Korver, MD.
"There is nothing like this equipment in the North Bay," says Candace Spring, nurse manager of the Cardiac Catheterization Lab. "Coronary angiography is the gold standard for diagnosing heart disease, and there is no better machine available than this. It takes pictures of the arteries, and the clarity of the images is phenomenal. That helps physicians make more precise diagnoses and treatment plans."
The angiogram procedure requires the attending physician to insert a long thin tube through a patient's leg, which the cardiologist deftly guides to the coronary arteries with the help of digital X-ray images that appear on the screen in front of him or her. When the site being examined is reached, the cardiologist injects a harmless dye, which the computer-assisted X-ray then tracks to determine where blockages are.
An added benefit of the all-digital unit is that it employs a highly efficient X-ray tube as well as a patented SpectraBeam X-ray filtration system. These innovations reduce the patient's radiation dosage by 50 percent or more over previous machines— without compromising diagnostic image quality. The resulting images are stored onto a CD for easy review and access by physicians.
One-Stop Cardiac Care
Korver and Coleman are two of the three cardiologists who serve as medical directors of the new Heart Center. Korver directs the surgical services and Coleman directs the Catheterization Lab. They are joined by the third director, well-known cardiologist Gregg Hopkins, MD, who is responsible for non-invasive cardiology procedures.
Hopkins founded the "Heart Smart" program of public education activities and seminars that has been a longtime fixture in the region's cardiac care. He will continue to expand those efforts as the Heart Center seeks first to prevent heart problems, and then to offer timely intervention and rehabilitation services when required.
"Our Heart Center significantly expands the opportunities available for patients in the area to get top quality cardiac care," says Coleman, an expert in nuclear cardiology and catheterization procedures who has practiced at Sutter Medical Center since 1992.
"Previously, we were equipped to do only diagnostic catheterization procedures here. Then, if we found a blockage in the patient that required an interventional procedure such as a balloon angioplasty, we would send the patient to another hospital. Now, we can do the interventional procedure right here. It's much more convenient and comfortable for the patient to get all their treatment under one roof. That can even include open heart surgery with Dr. Korver, who is a truly talented surgeon, highly respected through the entire region."
"Beating Heart Surgery"
Korver has performed hundreds of open heart surgeries during his medical career. His surgery team is on call 24 hours a day to address emergency situations, while also performing regularly scheduled heart surgeries.
In the past several years, Korver has mastered new minimally invasive surgical techniques that require smaller incisions and result in less post-surgical pain and faster recovery times. In addition, he has become an expert in "beating heart surgery," a revolutionary bypass procedure that now accounts for more than 20 percent of all coronary bypass surgeries.
In traditional heart bypass surgery, physicians use a heart and lung machine to take over the functions of the heart while the patient's heart is stopped and rendered motionless. This allows the surgeon to perform the delicate repair work on the patient's arteries before restarting the heart when the surgery is complete.
In "beating heart surgery," more officially referred to by surgeons as "off-pump coronary artery bypass," ingeniously designed suction devices allow the specially trained surgeon to literally pull and maneuver a beating heart into positions that allow access to the arteries being worked on. The heart never stops functioning as the surgery proceeds.
"Off-pump surgery is still a relatively new technique, but its use is increasing and the data we're getting shows faster recuperation, reduced hospital stays, and fewer of the complications that we sometimes see in bypass surgery, such as bleeding, strokes and mortality," says Korver.
After several years of using the off-pump procedure at other hospitals in the region, Korver and his surgical team performed four such surgeries in the first three months of the Sutter Heart Center's operation.
Looking Ahead
Cath Lab nurse manager Spring gives an indication of what might lie ahead in local cardiac care by citing demographic trends. With the baby boom generation just beginning to reach 50 and above in significant numbers, basic statistical analysis indicates greatly heightened demand for cardiac care in coming years.
"We needed to be ready for the increased demand in cardiac services," says Spring. "It's part of our responsibility to the community. Even with the success we're enjoying with prevention programs such as those run by Dr. Hopkins, the sheer numbers of baby boomers will challenge the health system's ability to provide interventional procedures such as catheterization and surgery. As a matter of fact, we're already seeing strong demand for our services—not only from Sonoma County patients, but up through Mendocino, Lake and Humboldt counties as well. That will only intensify as the population ages."
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