Angioplasty Okayed At Saints Metro

July 9, 2004
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GRAND RAPIDS — State approval for Metropolitan Hospital and Saint Mary’s Mercy Medical Center to perform an emergency cardiac procedure reflects the growing capability of smaller acute-care hospitals, Metro’s medical chief says.

When each launches emergency coronary angioplasty, both hospitals will have the ability to treat — and no longer need to transfer — certain patients who come into their emergency rooms having a heart attack and requiring the procedure.

The state’s willingness to allow more hospitals to perform emergency angioplasty — a procedure that uses a balloon to open narrowed or clogged arteries in the heart and restore blood flow — reflects advances in medical technology and techniques that are enabling smaller hospitals to perform some procedures that have been done exclusively at larger, tertiary care centers, said William Cunningham, M.D., chief medical officer for Metro Hospital.

Emergency coronary angioplasty is among the medical services that have been perfected to the point where more hospitals can do it effectively and safely on low-risk patients under certain conditions, Cunningham said.

“It is the future of acute-care hospitals,” Cunningham said. “Community hospitals can do procedures as effectively and safely as tertiary care centers.”

Under state certificate-of-need regulations enacted a year ago, hospitals with cardiac catheter labs may seek approval to perform emergency angioplasty as a life-saving technique. The procedure was previously limited to hospitals with open-heart programs.

Proponents of the rule change argued that more hospitals, under certain conditions, could perform emergency angioplasty safely.

Until recently, Metro Hospital and Saint Mary’s transferred those patients to Spectrum Health, one of two hospitals in the market with open-heart programs. The other is Mercy General Health Partners in Muskegon.

Research data shows that angioplasty is most effective for heart attack patients when done within an hour of the onset of symptoms. Eliminating the time to transfer a person to another hospital increases the patient’s chances for survival and recovery.

Metro Hospital and Saint Mary’s received approval in late June from the Michigan Department of Community Health to perform emergency coronary angioplasty for patients deemed low risk.

“This approval is definitely in the best interests of our patients,” said Michael Vrendenburg, M.D., chief of cardiology at Saint Mary’s.

Holland Community Hospital has a request to the state pending and spokesman John Speeter expects approval to come by Aug. 1.

Saint Mary’s expects to perform at least 48 emergency angioplasty procedures — also known as percutaneous coronary intervention, or PCI — in the first year of service and an increased volume in subsequent years. Saint Mary’s plans to begin performing the procedure late next spring at the earliest.

Metro Hospital anticipates performing 25 PCI procedures in the first year and 50 in the second year. The hospital plans to launch the procedure this fall, Cunningham said.

State CON rules require a hospital lacking an open-heart program and wanting to perform emergency angioplasty to show that it’s done 400 diagnostic cardiac catheterizations in the last year, has at least two experienced interventional cardiologists who have performed at least 75 procedures annually in the last two years, and has a written agreement with an open-heart facility to address staff training, credentialing, case reviews and the transfer of patients within one hour when needed.    

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