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Matters of the Heart

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Generous Hearts

Generous Hearts

Cardiac Care on the Northshore

by Karen B. Gibbs

“I was a ticking time bomb,” says Slidell Mayor Greg Cromer. “I had no symptoms except shortness of breath while working in the yard, but I just attributed it to getting older.”

Cromer’s good friend, Dr. Vasnath Bethala, head of cardiology at Slidell Memorial Hospital, had been “urging” Cromer to get a baseline cardio work-up. Finally, Cromer relented. “I was supposed to get a stress test on September 1, but Ida threw a kink in that plan. In no hurry, I put it off until September 30.”

Cromer’s stress test revealed something Dr. Bethala didn’t like, so he recommended Cromer get an angiogram. “I put that off for a week until my wife got back in town,” he says, obviously not worried about the outcome. But he should have been.

Slidell Mayor Greg Cromer.

The angiogram revealed that Cromer had nine blockages— one was 99 percent, two were 90 percent, one was 70 percent and the rest were between 40-50 percent blocked. He needed surgery immediately. Fortunately, Dr. Gregory Eckholdt, a cardiothoracic surgeon, had done several cases that morning and was still at the hospital. Dr. Bethala told him he had a case that needed to be done immediately, and Dr. Eckholdt agreed to do it.

“I went from the cath lab to the OR,” says Cromer. “I’d gone for the angiogram around 7:30 in the morning on Thursday. The surgery was done around 11 a.m. I woke up at 12:05 Friday morning in an ICU room, not knowing where I was or what was going on. I had tubes everywhere. Drew TK, my nurse in ICU, sprang into action. He hovered over me, rubbing both my arms to calm me down. He told me to relax and let me know what was going on. I went back to sleep.”

At the time he related this story, Cromer was just five weeks post-surgery and was feeling fine. He had nothing but praise for SMH. “My advice is this. If you need cardiac care, there’s no reason to go anywhere but the hospitals we have on the northshore. The care was first class—from the doctors, nurses, attendants, pulmonary and dietary staff—everyone provided first-rate care. They saved my life.”

Be Proactive

Mayor Cromer’s story has a happy ending because he listened—albeit grudgingly—to his friend, Dr. Bethala, and got a baseline cardio workup. If you are experiencing chest pain, shortness of breath, dizziness, and palpitations or fainting, talk to your primary care physician about seeing a heart specialist. You’ll be happy to know there are plenty of highly qualified, experienced cardiologists here on the northshore.

The Slidell Memorial Hospital Heart Center has comprehensive cardiac care to screen, identify and treat coronary, heart and vascular diseases. Featuring two catheterization labs and a hybrid cath lab/OR, cardiac procedures include: angiogram, balloon angioplasty, coronary artery bypass graft, valve replacement, stents, pacemakers and electrophysiology. Impella®, the world’s smallest heart pump, is available to support high-risk patients during heart surgeries and procedures.

Diagnostic Tests and Procedures

If you are referred to a specialist, a cardiologist may do a baseline cardio workup. This could include an EKG, a stress test to measure your heart’s performance during exercise, and an echocardiogram, which is an ultrasound that examines heart function, chambers, valves and blood flow. Echocardiogram machines are 3D-capable to give physicians more tools to make a diagnosis. The doctor may also include a nuclear scan to see how well blood flows to the heart muscle.

Some of the other heart-related diagnostic procedures that are available on the northshore include:

Calcium Scoring—Using 64-slice CT imaging, this non-invasive diagnostic tool can predict a patient’s level of coronary artery disease or cardiac risk. The higher the calcium score, the higher the risk of experiencing a cardiac event.

Coronary CT Angiography (CTA)—A non-invasive procedure, it uses CT imaging to screen for vascular and heart disease and hardening of the arteries.

Electrophysiology Studies—These map electrical conduction of the heart and are used in ablations.

Cardioversion—During this procedure, the heart is shocked into normal rhythm.

Radiofrequency Ablation—Using radiofrequency energy (similar to microwave heat), a catheter with an electrode on its tip destroys a small area of heart tissue that is causing rapid and irregular heartbeats. Doing so helps restore the heart’s regular rhythm.

Pacemaker—A small, battery-operated device that helps the heart beat in a regular rhythm.

Cardiac Defibrillator—An implantable device that monitors your heart rate and delivers a strong electrical shock to restore the heartbeat to normal when the heart rate is too fast.

Thanks to a partnership between Ochsner Northshore and Slidell Memorial Hospital, cardiology patients can be effectively treated at both hospitals. Cardiac patients who require only medical-type treatment are still treated effectively at OchsnerNorthshore. Patients who need interventional procedures like catheterization and bypass surgery, are transferred expediently by ambulance to SMH, just 1.8 miles away, and can be in the cath lab usually in less than 60 minutes.

The Cath Lab

Cardiac catheterization provides an excellent way to diagnose and treat some heart problems. These procedures are performed in a cardiac catheterization lab, “cath lab,” a specialized area in the hospital that is equipped with state-of-theart imaging technology used to view the arteries and check how well blood is flowing to and from the heart. With this information, doctors can diagnose and treat blockages and other problems in the arteries, often without patients needing to undergo surgery. Some of these procedures include:

Coronary Angiogram—The most common type of cardiac catheterization, this procedure uses dye and X-ray imaging to see if there’s a restriction in blood flow going to the heart. The X-ray machine rapidly takes a series of images, called angiograms, which give your doctor a look inside your blood vessels. Using a thin, plastic tube inserted into an artery in the arm, neck or leg, the doctor can do a variety of diagnostic tests and treatments on your heart.

Balloon Angioplasty—If there is a blockage detected during the coronary angiogram, your doctor can open the blockage by threading a deflated balloon through the plastic tubing in the arteries up to the coronary arteries. The balloon is inflated to widen the blocked areas where blood flow to the heart has been reduced or cut off.

Angioplasty with Stent—Using a balloon catheter, a thin metal stent is moved into a narrowed coronary artery. When the balloon catheter is inflated, the stent expands and is permanently fixed in place to keep the coronary artery open.

Drug-eluting Stents—This stent slowly releases drugs to help prevent scar tissue from forming inside the stent. In older types of stents, scar tissue sometimes formed, causing another blockage and requiring placement of another stent.

North Oaks Medical Center, a Level II Trauma Center and Primary Stroke Center in Hammond, offers the latest and safest treatments in cardiology, interventional radiology and neurology. Recently recognized by the American Heart Association for treatment of patients with STEMI heart attacks (total/ near-total blockages), it is also the first northshore hospital to offer the groundbreaking Shockwave Intravascular Lithotripsy that uses sound waves to break up plaque in severely calcified coronary arteries.

Coronary Laser Angioplasty— Similar to angioplasty, except instead of using a balloon, the doctor uses a catheter with a laser tip that opens the blocked artery by vaporizing plaque with laser beams.

Atherectomy—Similar to angioplasty, except the catheter has a rotating shaver on its tip to cut away plaque from the artery.

Shockwave Intravascular Lithotripsy (IVL)—A groundbreaking minimally invasive treatment for severely calcified coronary artery disease, IVL uses sonic pressure waves to break up severe calcium deposits. In some cases, it can eliminate the need for open heart surgery.

Valvuloplasty—A non-surgical technique that uses dilation catheters to increase the flow of blood through narrowed heart valves. Inserted through the groin, the catheter is guided by X-rays to the narrowed area. The dilation catheter is inflated to make the heart valve opening larger and thus improve blood flow.

Transcatheter Aortic Valve Replacement (TAVR)—During this minimally invasive procedure a new valve is inserted without removing the old, damaged valve. The new valve is placed inside the diseased valve. Usually, patients spend only one night in the hospital instead of a 4-5 night stay with surgical valve replacement.

Named among the top 10% in the nation for heart care by Quantros/CareChex and rated high-performing for heart care by U.S. News & World Report, St. Tammany Health System is an accredited chest pain center with a TAVR-certified cath lab for non-surgical valve replacement and other non-invasive heart procedures. It also has electrophysiology capabilities for diagnosing and correcting faulty heart rhythm.

Surgical Heart Procedures

Impella-supported Procedures—For patients at high risk of complications or with severe heart disease, a tiny device call the Impella heart pump can be temporarily inserted through the skin and into the heart to help it pump during minimally invasive and surgical coronary procedures. This ensures that blood flow to critical organs is maintained.

Bypass Surgery—This surgery treats blocked heart arteries by taking arteries or veins from other parts of your body and using them to reroute the blood around the clogged artery and supply blood flow to the heart.

Heart Valve Replacement Surgery—During this openheart surgery, the surgeon replaces an abnormal or diseased heart valve with a healthy one. The Impella pump enables at-risk patients to undergo procedures such as this that would have otherwise been deemed too risky.

With four 24/7 cath labs and two cardiovascular surgical suites, Lakeview Regional Medical Center, a campus of Tulane Medical Center, offers quality cardiovascular interventions including angioplasty, complex and CTO interventions, coronary artery bypass and grafting, surgical Valve procedures, and minimally invasive TAVR for aortic valve replacement. Our surgeons and cardiologists use the latest techniques to repair heart abnormalities and diseased valves.

Door-to-balloon time

When someone is having a heart attack or a stroke, every minute counts. It’s just as important to receive care quickly as it is to have excellent doctors and equipment. That’s why door-toballoon time is critical. Door-to-balloon time is the amount of time that elapses between a patient’s arrival at the ER and the opening of the blockage in the cath lab. Nationwide, 90 minutes is the benchmark door-to-balloon time. Through diligence, streamlining, training and efficiency, northshore hospitals significantly beat this benchmark time with door-to-balloon times ranging from 47 to 67 minutes, depending on the hospital. And that’s something to brag about!

The Bottom Line

The northshore is blessed with the exceptional doctors, medical staff, hospitals, diagnostics, interventions and surgeries needed for your cardiac health. If you call the northshore home, remember that home is not only where your heart is—it’s where your heart care is, too.

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