With the opening of a state of the art catheterization lab, Burdette Tomlin Memorial Hospital gives heart patients the opportunity to receive sophisticated diagnostic services here for the first time.
Although the lab just opened last week for those patients, Burdette received its license from the state Department of Health and Senior Services Dec. 5 and 20 procedures have been done since the new equipment was first put to use Dec. 7.
The hospital’s interventional radiology staff performed those procedures, which is why the full name for the new facility is Cardiac Catheterization Laboratory and Interventional Radiology Suite. It is on the ground floor of the hospital in an area that previously housed the billing department, which has been moved off-site.
This is “an exciting day for residents who had to travel out of the county,” Joanne Carrocino, president and CEO told invited guests to the official ribbon-cutting ceremony Dec. 15.
Chief of Cardiology Michael Boriss said, besides convenience, it will “provide much more efficient care.”
Boriss, who is one of five cardiologists that practice at the hospital, will oversee the operation of the lab. Co-medical directors will do procedures — Dr. William J. Untereker of Presbyterian Hospital in Philadelphia and Dr. Douglas Davies, who came to the county in March to work in the new lab.
“It adds some panache to the hospital with the relationship with Presbyterian,” said Boriss.
Up to now, patients requiring catheterization as a method for checking the extent of blockage in heart arteries were transported to Presbyterian, unless they chose another hospital.
“We at Presbyterian have enjoyed our relationship with Burdette,” of taking transfer patients, said Untereker. “Now we look forward to performing low-risk catheterization procedures.” Davies was not present for the opening ceremony because he had office hours.
High-risk patients will still be transported elsewhere for a very practical reason. The procedure could lead to diagnosis calling for immediate surgery and Burdette is not licensed to perform heart surgery, according to Boriss.
But at least half of the patients, whose cardiologists call for the procedure, said Untereker, about 300 to 400 annually, are low risk and will be able to be treated here.
This will be much easier on patients, said Boriss who may need to be transported by family members, especially with “the age of the population” here.
And it is only the beginning.
“The hope is to do angioplasty treatments,” said Boriss, if numbers justify that added service.
Where the new diagnostic treatment involves the insertion of a catheter through an artery in the groin to the heart, the injection of dye and then the visual examination of the heart via X-ray, angioplasty is a medical procedure performed in lieu of surgical intervention.
A balloon is inserted to “dilate narrow or blocked” arteries, said Boriss.
Once that is done a patient can be treated with medication if necessary and can receive all services locally.
In addition to Untereker and Davies, there are three nurses specialized to work with heart catheterizations and a radiation technologist. They were not hired for the new service. Rather, the hospital looked to its staff and with the help of a consulting agreement with Cooper University Hospital trained four Burdette staff members to work in the new lab.
Tom Salerno, an R.N. and assistant nurse manager at the cardiac catheterization lab at Cooper, said he helped Burdette with planning, administration, staffing and education of staff over the past three months. He will continue to work with them for a couple more months, under the consulting agreement, he said.
He said the four members of Burdette’s staff “came to Cooper for four weeks of training” and he also conducted in-services here on pre and post procedure care.
Keith Babore, technical director of imaging, said of the new equipment, “this X-ray system is the latest and the greatest” and includes digital technology.
It has “all flat panel detectors,” which is akin to high definition television, said Babore. The radiation dose is less and there is finer detail of structures being viewed, he said.
Although interventional services are not new and angioplasty treatment has been available to patients, including those with vascular disease and those on dialysis, with the new equipment, said Babore, it’s a difference of quality.
For physicians, it provides “better image quality,” he said.
There are three digital screens in the patient treatment area, two which show the procedure and one which tracks the patient’s vital statistics, said Babore. There are also five monitors in the enclosed control room where technicians monitor procedures.
Stacey Esham, an interventional radiology technician, said the “upgrades are tenfold,” compared to what was available before.
“We are able to offer services we were not able to before,” she said. “We have been able to add vertebroplasty,” she said, which treats spinal fractures caused by osteoporosis.
“It’s the top of the line compared to any facilities in the area,” said Esham.
Thrombolytic therapy, which uses a balloon to clear a closed leg artery, is an alternative for someone who might otherwise lose a leg, said Esham, shaking her head, not able to really express how it makes her to feel to help a patient in that position.
Heart catheterizations are elective surgeries that can be done on an in-patient or outpatient basis, said Untereker, “about half would be out-patient.”
“Twenty years ago,” he said, “this would only have been done at a specialized heart center. But the procedure has gotten safer in two ways, the X-ray contrast (dye) is safer and the catheter’s are smaller and safer.”
The science has also improved, he said. “We know who’s highest and lowest risk.”
Those who would not be candidates for the new lab would include those with unstable symptoms, said Untereker, such as chest pain that can’t be controlled with medicine.
If a patient were pain free for 24 hours with medication they would be considered low risk, absent other symptoms, according to Untereker.
“It would also be inappropriate for somebody with a very weak heart muscle,” he said, or someone with a “recent heart attack,” unless the condition was stable for three days.
“The state has concrete guidelines,” he said.
Herbert L. Hornsby Jr., chairman of Burdette Tomlin Health System Board acknowledged the half dozen members of the hospital’s auxiliary that were present.
“They asked what they could do and were told it’s expensive, a $2.9 million project” said Hornsby, but the group pledged to raise $500,000 in five years and have “already paid $330,000 in just over two years.”
He said the new service is a result of “cooperation of staff and willingness to bring in affiliations, thanks to a new administration,” a nod to Carrocino who came here to run the hospital in April 2004.
“It’s one of the many exciting things going on here,” said Boriss. “It shows what can happen when medical staff and administration work together.”
According to Thomas Piratzky, vice president of public relations and marketing, the construction of the facility was “just about on schedule.” Although he could not say whether it had come in under the $2.9 million budgeted, he said, “I know it didn’t go over.”
Contact Cote at: ccote@cmcherald.com
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