Upgrades keep heart patients closer to home

MORGANTON — Cardiologist Sanjay Patel, M.D., recently made history in Burke County by performing the first cardiac intervention in Blue Ridge HealthCare's new Heart and Vascular Center.

Procedures such a heart catheterizations have been performed by local cardiologists at Grace Hospital's cardiac catheterization lab since 2004.

Now, due to recent upgrades in the lab including acquisition of an all-digital cardiovascular and interventional X-ray imaging system called the Innova®2100IQ, cardiac operations including angioplasty and coronary stents can now be performed at Blue Ridge HealthCare.

"The visualization you get out of this system and equipment is comparable to what is found in the best heart centers in the country," said Jerry Davis, vice president of marketing and public affairs.

Cardiologist Anthony Bracken, MD, FACC, was brought in from Sanger Heart Clinic to start the interventional program. He's now medical director of the Heart and Vascular Center.

The imaging at the hospital is "awesome," Bracken said. "The ultrasound device allows you to actually image the inside of the artery and the artery lining to see the cholesterol and plaque build up."

"With technology upgrades, along with recruiting doctors, we can do procedures that had been leaving the county," Bracken said.

"To put in stents or do angioplasty in the arteries you need very good imaging. What we had before was fine for diagnostic testing, but not the level we needed for stent placement."

Patel added, "This allows us to do more because we can see more clearly and the procedure is a lot safer for the patient."

According to Bracken, this is a major step forward and the benefactor of the quality equipment and images are the patients.

More than 200 patients each year were going outside Burke County for procedures that now are available from local specialists utilizing the state-of-the-art technology, according to BRHC.

"In the past, when a doctor came upon a blocked artery and if it was determined there was a blockage that needed angioplasty or a stent, they were sent to another hospital," Bracken explained.

These procedures relieve symptoms such as chest pains or help find the cause of a positive stress test.
Balloon angioplasty is performed if, following a cardiac catheterization procedure, arterial blockages are identified — a condition found in 25 to 30 percent of people who undergo catheterization.

The doctor performs an angioplasty by using a balloon-tipped catheter to press fatty deposits against an artery's wall, widening the opening for blood flow. Then a small scaffolding device, called a stent, is placed in the artery to hold it open.

Patel said, "We have all the latest stents that are the standard of care everywhere."

Sanger Heart and Vascular Institute at BRHC, Hickory Cardiology Associates/Western Piedmont Heart Centers and Piedmont Cardiology are currently approved to perform angioplasty or implant coronary stents at BRHC's Heart and Vascular Center.

Recruitment of interventional cardiologists as well as the expansion of lab capabilities were both necessary in order to provide the procedures locally.

Bracken said said technicians experienced in intervention also were hired along with nurses with experience taking care of patients who have had these procedures.

The hospital also added a special unit where patients can stay overnight.

In addition, BRHC set up agreements with nearby hospitals and heart surgeons for surgical backup. Although problems are rare, Bracken said, the agreements and transfer procedures are good practices.
One of those backups is based on Western Piedmont Heart Centers' 20-year-long relationship with the cardiac surgeons at Frye Regional Medical Center in Hickory.

If a patient undergoing balloon angioplasty develops an emergency situation requiring heart bypass, they can be sent by ambulance directly to Hickory in under 20 minutes.

Patel said, "The safety mechanisms are in place so even if there's a small chance of something going wrong we can take care of them in a timely fashion."

According to Bracken, "Studies have shown it's a safe procedure to do in a hospital without surgical backup. Thirty-eight states and over 40 European countries do this. I wouldn't be involved if I didn't think it was a safe thing to do."

"We have specific criteria for patients we do here," he added. "We don't do high-risk patients."

Most standard stent procedures require overnight observation, Bracken said. The benefits for both patients and their families include less travel time and the convenience of staying close to home.

Patel performed the first-ever cardiac intervention at Grace Hospital on Sept. 29. The patient was referred to the Western Piedmont Heart Centers' group by another local cardiologist, Dr. Roger Seagle of Cardiology Associates of the Carolinas.

"It was an exciting moment for Western Piedmont Heart Centers to be able to perform that procedure for our patient," Patel said. "The patient was doing well and went home the next day."

According to Davis, "This is part of the goal of our system for people who live in Burke and the other counties we serve. They should be able to receive 85 percent of the care they would need in their lifetime here in their community.

"This was a major step forward putting this program, this technology and these physicians in place to take care of the top one or two health problems in this community."

Anna Wilson at Blue Ridge HealthCare and Amanda L. McKinney of Western Piedmont Heart Centers/Hickory Cardiology Associates contributed to this story.