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Medical Center of Trinity adds open-heart surgery

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Published:   |   Updated: February 18, 2014 at 02:37 PM

TRINITY — The first open-heart surgery at Medical Center of Trinity could take place this week, hospital leaders said, during National Heart Month.

The hospital has more than 20 nurses and other staff, CEO Leigh Massengill said last week. Three cardiac surgeons earned privileges to perform the additional procedure.

Intensive training and exercise drills have taken place since July for consistent treatment.

Staff practiced the “what ifs,” Massengill remarked, should everything go smoothly or if an emergency develops, such as a patient going into cardiac arrest in an elevator before reaching the operating room.

“So we are ready for the real thing,” Leela Beers, director of business development for cardiovascular services, said.

While Medical Center of Trinity opened a bit more than two years ago, the building at 9330 S.R. 54 was designed from the ground up for facilities needed to perform open heart surgeries, Massengill said.

For instance, a “huge” elevator goes directly to the cardiac intensive care unit, according to registered nurse Bobbi Altman, director of cardiac catheterization.

The cardiovascular team already offers a wide array of heart care, including vascular services, minimally invasive cardiac catheterization and diagnostic testing. The plan from day one was always to add open-heart procedures, Altman noted.

Two surgeons in particular went above and beyond the call of duty to help set up the open-heart program, Massengill stressed. Marshall DeSantis, a cardiothoracic surgeon, and Nirmala Konda, a cardiovascular anesthesiologist devoted a lot of time. DeSantis alone has done more than 4,000 open-heart operations.

When it came time to hire nurses, “we were amazed” at the deep talent pool from West Pasco, Nancy Maysilles, the hospital’s chief nursing officer, said. Many leaped at the chance to work at Trinity instead of long commutes to Largo and other hospitals in the region. Some staff members saw their 55-minute commutes shrink to 5 minutes.

A data quality manager came on board as well, Maysilles said. One nurse from Maine had extensive knowledge about best-practices methodology, such as very tight blood sugar controls.

Weekly meetings since July brought together a focus team drawn from many departments, including catheterization laboratory, blood bank, surgeons, anesthesiologists, respiratory experts and many others.

“We want to start out as the best,” Maysilles said.

Medical Center of Trinity already has developed an enviable reputation in cardiac care, Altman said.

Hospital officials express pride in times for emergency treatments. D2B times measure how long it takes once a cardiac patient comes through the door and a balloon is inserted and inflated to prop up a narrowed or blocked coronary artery.

Hospital staff logged D2B times as low as 32 minutes, according to Altman. The hospital average is 60 minutes, far below the national standard of 90 minutes.

Stents are another option to open clogged arteries.

New techniques have shortened the time patients must remain in the hospital. Surgeons who once had to make 10-inch incisions now can make cuts as small as three to four inches.

Minimally invasive catheter treatments have resulted in fewer open-heart surgeries, Maysilles commented. But in many cases open-heart remains the best option.

It depends on the location of the lesions on the heart, Altman explained. Problems with the left anterior artery often pose the greatest risks. Aortic valve replacements also present challenges.

While the term “open-heart surgery” has been around for more than 50 years, people sometimes are confused exactly what it entails, Mary Sommise, a hospital spokeswoman, said.

The procedure spreads open the rib cage to the doctor can fixe or replace a heart valve or repair a coronary artery.

Two major advances made the surgeries possible, the heart-lung machine to support the patient’s circulation while the heart is stopped and body cooling techniques to extend time for surgery without causing damage to the brain.

Two of the most frequently performed procedures will be available at the hospital. Coronary artery bypass grafts a vein from a leg or other part of the body to circumvent a diseased artery. Valve repair or replacement includes a heart valve that does not close properly and blood leaks backward instead of moving forward in the bloodstream. Other times the valve leaflets do not open wide enough, limiting the blood flow.

Meanwhile, Medical Center of Trinity plans three presentations by interventional cardiologist in February as part of Heart Month. All events start at noon at the hospital at 9330 S.R. 54. A light lunch will be served. Reservations are required by calling (727) 834-5630.

On Feb. 19, Carlos Bayron will discuss “Heart and Soul,” about how recent scientific findings are linking music to hearts and heart health.

On Feb. 27, Rias Ali will talk about “I’m Having a Heart Attack, Now What?” Many times, the warning signs and symptoms are ignored and blamed on stress and fatigue. Not all heart attacks have shooting pain down your left arm.

On Feb. 28, Rami Akel will speak about “The Way to Your Heart from Your Wrist: Cardiac Catheterization Reinvented.” New methods use a small artery in the wrist with benefits to patients.

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