It was a busy 2017 in the cardiology program at IRMC, which started its Percutaneous Coronary Intervention, or PCI, program in late 2016.
“They can do cardiac catheterization, stents and treat emergency patients as well,” says Ian Brown, BSN, RN, CCRN, and director of cardiovascular services at IRMC.
In a catheterization, X-ray dye is injected into the coronary arteries and live pictures allow doctors to identify any narrowing or blockages in those arteries that need treatment.
“We can identify the culprit lesion or the vessel that’s blocked and we can intervene to open that up,” Brown says. “The idea is we can prevent heart attacks, and also treat an active heart attack.”
In the past year, IRMC has seen many patients.
“We do more than cardiac catheterizations,” Brown says. “But in one year, we saw 468 patients come through the cardiac catheterization lab. Of those patients, 194 have had PCI’s or some kind of a stent procedure.”
On average, IRMC sees 38 catheterizations, 16 PCI and four emergency heart attack patients every month, he says.
Covering all the bases
The facility prides itself on state-of-the-art technology. IRMC can perform ultrasound studies inside the heart, called “intravascular ultrasound.” And staff can perform fractional flow reserve, in which pressure is measured inside arteries to determine if a stent is needed.
“We want to make sure that when we put a stent in a patient, we’re doing the right thing,” Brown says. “It’s one of those quality things. That’s one of the biggest things I can say about Dr. Pillai is he is so on top of making sure, for the patient’s sake, that he is doing the right thing.”
Dr. Rajeev Pillai is medical director of the cardiac catheterization lab and has been with IRMC since July 2016.
“We brought him in to start this program,” Brown says. “He started a program at a hospital similar to ours in Virginia.”
Normally, hospitals with a PCI program in place must have an open heart backup program.
IRMC asked for and received an exemption from the state to perform the PCI procedures without the open heart surgery backup on site. IRMC has an agreement with Butler Hospital to transfer anyone needing emergency heart surgery. Butler is 57 miles away and patients can be transported there by road or air.
IRMC built the state-of-the-art cardiac catheterization lab, which was installed in August 2016 and opened in November 2016, after it met all state requirements.
“One thing is we have to have 24/7, 365 days a year coverage,” Brown says. “That means we have to have an interventional cardiologist and a full team that can come in at any moment, any day, within 30 minutes of being called.”
That’s not a problem, he says, and it’s much safer than driving 60 minutes to Butler Hospital or 90 to Pittsburgh when a patient is having a heart attack.
“If a patient is having a heart attack, you want to get that artery opened up as quickly as possible in order to restore blood flow and oxygen to the heart muscle,” he says.
Committed to improvement
A few years ago, IRMC committed close to $50 million for renovations. This included new operating rooms, ambulatory surgery center and intensive care unit. These improvements were made to support the program.
“We feel that we can best serve this community by increasing the ability to take care of really sick patients, and also to care for these heart patients in their community so they don’t have to go far,” Brown says.