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State-of-the-Art Interventional Cardiology Care Right in our Backyard

 

Since Lewes is a small, quaint town, it would be natural for people to expect that the local healthcare institution would be a small community hospital with a relatively low volume of advanced cardiac procedures. Many people, even those familiar with the hospital, would probably be surprised to find out, that from the standpoint of interventional cardiac care, Beebe is a moderate- to high-volume center, which has recently been recognized as one of the top 100 hospitals in the country for interventional cardiology care.

Beebe’s cardiac catheterization lab opened for diagnostic procedures more than 18 years ago, and it was more than 10 years ago that the first intracoronary stent was placed. Unlike what has occurred in many other institutions, the number of interventional cardiac procedures performed at Beebe has steadily grown from year to year since the program’s inception. The yearly volume of diagnostic cardiac catheterizations has grown to nearly 1,500 per year, while the volume of interventional procedures (angioplasty and stenting) has increased to greater than 500 procedures per year.

The cardiac catheterization lab is well-equipped with the most advanced technology, and is capable of handling the immediate needs of nearly every patient who arrives at Beebe Healthcare with cardiac problems. In addition to coronary stenting and angioplasty, we are also capable of providing procedures which include, but are not limited to, mechanical thrombectomy, orbital atherectomy, fractional flow reserve (FFR), intra-vascular ultrasound (IVUS), optical coherence tomography (OCT), pericardiocentesis, peripheral angioplasty and stenting, as well as percutaneous cardiopulmonary bypass (CardioHelp).

While most people may not be familiar with some, if not all, of the above-mentioned procedures, each has a role in providing optimal management of people with potentially life-threatening cardiac conditions. For example, coronary angioplasty and stenting is a minimally invasive procedure during which tubes are placed into the heart through the bloodstream. Dye is then injected through the catheters while X-ray imaging is used to identify cholesterol plaque build-up that leads to blockage of blood flow to the heart muscle. Through the small tubes, wires can be placed across the blockages. The blockages are then expanded with balloons (angioplasty), and then later pushed aside permanently with stents to restore normal blood flow to the heart muscle. In some cases, this procedure can be done electively (ie. routinely) to relieve stable symptoms of chest pain or breathlessness, and in other cases, it can be done urgently to abort heart attacks. In fact, at all hours of the day and night an interventional cardiologist, and a Cath Lab team, are available to be at the hospital within 15-20 minutes to perform emergent cardiac catheterization for patients coming to Beebe with heart attacks.

Our overall volume of procedures, continued steady growth, and nationally recognized superior outcomes as an interventional lab, has offered us, and more importantly our patients, the luxury of having access to the most advanced equipment and techniques. We currently have devices that can de-bulk cholesterol plaque and bore-through calcified blockages to optimize stenting results for our patients. We also have at our disposal an external heart/lung machine, called CardioHelp, that, through tubes placed into the large veins and arteries of the body, can entirely replace the work of the heart and lungs in patients whose vital organs are failing.

While we are proud of what has been accomplished, we are still always looking to improve upon what we are doing, and remain on the cutting edge. We have a number of new devices that are on our immediate horizon. Within the next couple of weeks we will be launching the first available absorbable coronary stent on the market. While all prior stents have been constructed with a stainless steel alloy, this new stent is constructed of a fully absorbable scaffold that will be used for selected blockages, and over a year or two following implantation will be absorbed by the blood vessel wall resulting in no permanent material being left behind. We will also soon acquire the Impella catheter, which can be inserted through the bloodstream, and into the heart, within a matter of minutes to unload the work of the left ventricle (the main pumping chamber of the heart), and assist the failing heart in patients with acute heart failure due to heart attacks, and other life-threatening cardiac conditions. And last, but not least, we are expecting by early next year to launch the Watchman device, which is designed for patients with atrial fibrillation (AFib) who cannot tolerate long-term anticoagulation. Using a minimally invasive technique through the bloodstream, the device can be inserted in the left atrium of the heart where clots form in patients with AFib. The device occludes the area where clots most commonly develop, thereby reducing the risks for stroke and other complications related to AFib.

Needless to say, it is an exciting time for us in the Cardiac Catheterization Lab at Beebe, knowing that we offer state-of-the-art techniques, and nationally recognized care to our community.

Robert Myers, MD, is an interventional cardiologist in Lewes. He recently received the 2016 Standards of Excellence award from Beebe Medical Staff. He performs procedures at Beebe Healthcare’s Medical Center in Lewes and practices privately with Cardiovascular Consultants in Lewes. For more information on Cardiac & Vascular Services at Beebe Healthcare, go to https://www.beebehealthcare.org/cardiac-vascular-services.