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Teamwork, wireless, surgical technology shave critical minutes

[caption id="attachment_17452" align="alignleft" width="314" caption="Memorial's new Heart & Vascular Institute houses the best equipment and fastest response team in the nation."][/caption]

SANTA ROSA -- Advances in communications technologies plus stopwatch teamwork have made Santa Rosa Memorial's heart attack response the fastest in the U.S.

In a week or so specialists from St. Joseph Health System hospitals throughout California, Texas and New Mexico will visit the Heart & Vascular Institute to see how it got its door-to-balloon time down to an average of 62 to 65 minutes.

That's close to half the 120 minutes once considered critical for survival and recovery of patents suffering from an acute myocardial infarction, and well below the national average of 99 minutes.

"When clogged arteries are blocking the flow of oxygen-rich blood to the heart, every minute counts," said Trish Scalercio, manager of the Santa Rosa Memorial cardiac catheterization lab.

"The quicker we restore blood flow to the heart, the greater the patients' chances of survival, full recovery and minimized heart muscle damage."

Memorial's door-to-balloon time is the highest-ranking out of the 949 hospitals in the U.S. that have cardiovascular teams and are tracked by the American College of Cardiology Foundation's National Cardiovascular Data Registry.

"We've worked up to this over a span of 25 to 30 years," said Dr. Gary Greensweig, chief medical officer of St. Joseph Health System – Sonoma County.

The ranking "is one piece of a series of landmarks of excellence."

The Heart & Vascular Institute, opened a year ago, is the culmination of seven years of planning. Its cardiac catheterization lab is equipped with cutting-edge medical imaging technology.

The ranking, Dr. Greensweig said, is primarily the "result of building a team that functions like a highly refined piece of technology itself, and it's a continuing journey. We continue to gather data from every case we get, shaving off seconds wherever possible."

Recently, three patients suffering from the symptoms of acute myocardial infarction were admitted in quick succession. Not knowing which to treat first, the team treated them in the order in which they arrived, discovering later that the last patient admitted was the one most in need of speedy treatment.

"We now have a system in place to analyze symptoms quickly and determine where to triage in case of multiple patients," he said.

Wireless technology plays a major role in quick response, allowing ambulance technicians to collect and transmit electrocardiogram data well in advance of the patient's arrival at the emergency room door.

[caption id="attachment_17451" align="alignright" width="314" caption="Cutting-edge technology in the cardiac catheterization lab adjacent to surgery"][/caption]

From there, a multidisciplinary team takes over, including EKG specialists, consulting cardiologists, emergency physicians and nurses, who prepare, drape and employ balloon dilation on patients to restore blood flow to the heart.

"We achieved a major time savings by relocating the technology," said Dr. Greensweig. "Putting the cardiac catheterization lab next to the emergency room shaved two to five minutes from the door-to-balloon time."

The Memorial team further honed the process by endoscopically harvesting veins from the leg needed for the coronary artery bypass graft.

"Endoscopy, which uses a video camera and very small incision to remove the vein, offers a much faster recovery time, shorter hospital stay, less pain and scarring," said Dr. Greensweig.

Another advanced medical technology in use by the surgery team is "beating-heart surgery."

Surgeons use a special device to stabilize the part of heart they're operating on so that the heart continues to beat and circulate blood to heart muscle during the operation.

The procedure helps reduce the complications that can result from stopping and restarting the heart.