Springfield hospitals celebrate advances in cardiac care

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St. John's Regional Health Center recently celebrated the 30th anniversary of its first heart surgery. On April 24, 1972, a well-practiced medical team gathered to perform the double-bypass surgery. |ret||ret||tab|

The surgeons who performed that procedure were Ramon Shane, MD, who started the heart program in Springfield in 1968, and Fritz Johnson, MD, who joined St. John's in 1971 and served as the lead surgeon in the historic operation. Their success led to cardiovascular surgery becoming a medical specialty for the hospital. |ret||ret||tab|

The new program at St. John's was a significant achievement in part because it signaled the early movement of such medical technology beyond research facilities into community hospitals. |ret||ret||tab|

Previously, southwest Missouri patients in need of cardiac care had to travel to St. Louis, Houston or Cleveland, according to Charles Wollard. |ret||ret||tab|

Wollard, who's now St. John's vice president of heart services, served on that first surgery team as the clinical perfusionist the person responsible for operating the heart/lung machine that provided life support for the patient. Wollard and two other original team members, Lynn Gaston, RN, surgery, and Darlene Vanderford, RN, surgery, still work at St. John's.|ret||ret||tab|

Wollard recalls the tension of a new procedure, but mostly he's proud of the success of the first open-heart surgery at St. John's. |ret||ret||tab|

"We had practiced and worked together for many months, so we were very well prepared. Everything went very well." |ret||ret||tab|

In the last 30 years, Wollard said, there have been "tremendous changes in technology." These improvements include methods, such as blood oxygenation and anesthetization, and equipment, such as tubing, connectors and monitoring systems. The result is better success and improved post-surgery quality of life, not to mention that patient recovery time has been reduced by more than 50 percent. |ret||ret||tab|

At St. John's some of the most recent advances include transmyocardial revascularization and an endovascular procedure used to treat abdominal aortic aneurysms. |ret||ret||tab|

In April 2001, St. John's began offering transmyocardial revascularization to treat chest pain caused by angina blocked arteries that keep necessary oxygen from the heart. According to information from St. John's, Dr. Clyde Redmond performs TMR on patients who are not candidates for bypass surgery or angioplasty. For TMR, a small incision is made in the chest wall, exposing the heart. A laser is then used to make several small channels, or holes, in the heart's pumping chamber. There are 20 to 40 laser channels placed during the procedure, and each is about the size of a sewing needle. Studies have shown that the angina in 80 percent to 90 percent of the patients who received TMR had significantly improved by at least 50 percent up to one year after the surgery. |ret||ret||tab|

In the past year, St. John's also has begun to use a new treatment that offers an alternative to conventional surgery, to treat abdominal aortic aneurysms, or AAAs. AAAs are bulges in the aorta, the main artery that carries blood from the heart to the other organs. The new treatment is an endovascular procedure that requires two small incisions in the groin. With the use of an X-ray imaging device, a graft is guided though a blood vessel in the leg to the aorta, and then placed inside the aneurysm. The procedure takes only two to four hours, and patients are kept in the hospital for two to three days for observation. Once released, they can return to normal activity within two weeks. |ret||ret||tab|

Another angina treatment offered by St. John's is enhanced external counterpulsation, a therapeutic program that stimulates the flow of blood from the lower extremities to the heart. The EECP system consists of an air compressor, a console, a padded treatment table and three pneumatic cuffs. |ret||ret||tab|

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Cox advancements|ret||ret||tab|

Cox Health Systems also has made notable contributions to cardiac care.|ret||ret||tab|

Donna Willoughby, a nurse at Cox, remembers the excitement she witnessed as a second-year nursing student in the mid-1960s when St. John's and Cox worked together to bring the first defibrillator to Springfield, and to develop the first coronary care units at both facilities.|ret||ret||tab|

Cox was the first to begin educating nurses to read EKGs. Cox obtained a government grant and established a training program, which it opened to nurses throughout the region.|ret||ret||tab|

In another groundbreaking move, Willoughby said, "in 1971 Cox developed the first mobile coronary care unit in Springfield, one of only 50 in the United States."|ret||ret||tab|

Prior to that time, the only ambulances and paramedics were in large cities and under the auspices of fire departments, and they lacked the equipment and training to give coronary care. |ret||ret||tab|

Prehospital services (ambulance and helicopter) have improved drastically in recent years. Donna Barton, public relations assistant at Cox, explained that the use of TNKase (an advanced "clot-busting" drug) and LifePack 12 (a cardiac monitor/defibrillator/pacemaker that can transmit EKG information from the mobile unit to any fax), give cardiac patients faster and better treatment.|ret||ret||tab|

Dr. Keesag Baron, an electrophysiologist at Cox, has created a microwave wand that disrupts the faulty electrical activity that causes arrhythmia. Called microwave oblation, this technology is already evolving. In February, the FDA approved a new generation of the wand that "allows a surgeon to perform the procedure in a minimally invasive technique."|ret||ret||tab|

Doctors at Cox also may have solved the problem of coronary stents clogging up over time, thus requiring bypass surgery to restore blood flow. Drs. James Ceaser, John Clouse, and John Pacynlak pioneered brachytherapy, a technique that uses small amounts of radiation to destroy tissue blockage.|ret||ret||tab|

These advances allow medical personnel to arrest heart damage so that, in many cases, surgery can be avoided. |ret||ret||tab|

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