Parrish Medical Center (PMC) to perform elective coronary angioplasty and stenting.

Parrish Medical Center Granted State Approval to Perform Elective Angioplasty and Stenting

TITUSVILLE, FL (January 28, 2009)—The State of Florida Agency for Health Care Administration (AHCA), which regulates hospital services, has granted Parrish Medical Center (PMC) approval to perform elective coronary angioplasty and stenting. This comes just over one year after the medical center sought and earned approval from AHCA to perform these procedures on an emergency basis. 

“This is truly exciting news,” said PMC Chairman of the Board Jay Parrish, III. “This latest achievement is another example of Parrish Medical Center’s commitment to quality and excellence. We, the entire board of directors, are extremely proud of the hard work and dedication required by everyone involved to earn this achievement on behalf of the community we serve.”

“Earning state approval to perform elective angioplasties was our goal over a year ago when we applied for, and earned, emergent approval,” said PMC President/CEO George Mikitarian. “We knew legislation was being considered to expand AHCA rules from emergent to elective, so our team was proactive in developing a world-class cardiovascular program to a level that exceeds national quality best-practices,” said Mikitarian.

“Hospitals everywhere are striving to shorten the time a heart attack patient waits before receiving angioplasty,” said board-certified Interventional Cardiologist Biju Mathews, MD. “Our time-to-treatment not only exceeds national best practices standards, but our team outperforms even those centers with open-heart surgery on-site,” said Mathews. 

“The national best practice time-to-treatment goal is 90 minutes. PMC’s time-to-treatment is 60 minutes or less, which is a full 30 minutes better than the best-of-the-best nationally,” added Harvard-trained board-certified Interventional Cardiologist Ravi Rao, MD.

The state requires and evaluates quality indicators like time-to-treatment, training of staff and cardiologists and other indicators as part of its approval process. 

Coronary angioplasty is a procedure performed inside a catheterization lab to open clogged arteries in response to a heart attack. The procedure quickly restores blood flow through blocked arteries without the need for invasive open-heart surgery. 

OR LIVE

CARDIAC STENTING

 
“With the advances in technology today, open-heart really is a last-resort intervention,” said Rao. “A majority of heart interventions and treatments can and are effectively performed in a catheterization suite and we are fortunate to have the newest, state-of-the-art cath suites available anywhere right here at PMC,” Rao added.

PMC’s cardiovascular program includes highly credentialed, board-certified interventional cardiologists Chapman Bean, MD, Biju Mathews, MD, and Ravi Rao, MD, and board-certified cardiologists David McMahon, MD, Kiran Modi, MD, Naresh Mody, MD, and Surya Rao, MD. 

Cardiovascular services provided at PMC include: 

Cardiac catheterization 
Emergent coronary angioplasty and stenting 
IVUS – Intravascular Ultrasound 
Peripheral angiography, angioplasty, stenting and atherectomy 
Carotid angiography 
Permanent pacemakers, including biventricular pacemakers and implantable cardiac defibrillators (ICDs) 
Cardiac and peripheral ultrasound, including echocardiograph, carotid artery and lower extremity arterial studies 
AACVPR certified cardiac rehabilitation (outpatient) 
Stress testing and all routine cardiac tests and treatments

Complementing the cardiovascular services at PMC are the four disease-specific Gold Seals for excellence and quality in the areas of Acute Coronary Syndrome, Heart Failure, Diabetes and Stroke from The Joint Commission, the premier accrediting organization for healthcare systems in the nation. PMC has earned a total of seven Gold Seals for quality and excellence, more than any other hospital in the area. In addition to those related to cardiovascular disease, PMC has Gold Seals in Breast Health, Palliative Care and Wound Healing.

Parrish Medical Center, nationally recognized as “one of America’s finest healing environments®” was voted America’s # 1 Healing Hospital and named a Modern Healthcare Magazine Spirit of Excellence Award Winner. PMC is a 210-bed, not-for-profit public medical center serving North Brevard for over 50 years. For more information, visit parrishmed.com or call 321-268-6110.

 

What is coronary angioplasty?

If you have coronary angioplasty, a doctor will use a tiny balloon to open a narrowed blood vessel in your heart. The aim is to stop or reduce chest pain, lower your chance of a heart attack and help you to live longer.

Why do I need coronary angioplasty?

If the blood vessels to your heart have been narrowed by heart disease, you may need coronary angioplasty to widen them.Your coronary arteries supply your heart with blood and oxygen.

Your heart is a muscle about the size of a fist. It has its own blood vessels calledcoronary arteries. These arteries bring the heart muscle the oxygen it needs to keep pumping blood round your body.

If you have heart disease, the insides of your arteries get coated with fatty patches. Over the years, these patches make parts of your arteries furred up and narrow. This makes it harder for blood to get through them. If this happens in your heart, you may get pain in your chest. This pain is called angina, and it happens because your heart isn’t getting enough oxygen. You may only get angina when you exercise, because that’s when your heart needs more oxygen. But you can also get it when you’re not doing anything. If one of the arteries in your heart gets completely blocked, you can have a heart attack.

To find out if angioplasty will help, you need a test called an angiogram. This is an X-ray that shows up any narrow parts in your arteries. A doctor will thread a thin, hollow tube into an artery in your groin or arm. Dye is put through the tube and flows through your bloodstream to your heart, showing up any narrow parts in the arteries there. You can sometimes have angioplasty at the same time as the test if you agree with your doctors beforehand.

Doctors may suggest angioplasty if:

  • You still get chest pain even though you are taking tablets for angina
  • The X-ray shows a narrow part in the arteries in your heart and your doctor thinks it’s causing your chest pain
  • Your doctor thinks the narrowing can be opened up by angioplasty (short, straight narrow parts are easiest to open up)
  • You have had bypass surgery on your heart but an artery has furred up again.

If you do have angioplasty, you’ll still need to take tablets. If you’re overweight, you may need to lose weight. If you smoke, you should do everything you can to stop. Smoking makes any treatment less likely to work.(source)
 

 

 


Stent Procedure  

 

 
stent
 

What is a stent and how is one used?

A stent is a wire metal mesh tube used to prop open an artery during angioplasty. The stent is collapsed to a small diameter and put over a balloon catheter. It’s then moved into the area of the blockage. When the balloon is inflated, the stent expands, locks in place and forms a scaffold. This holds the artery open. The stent stays in the artery permanently, holds it open, improves blood flow to the heart muscle and relieves symptoms (usually chest pain). Within a few weeks of the time the stent was placed, the inside lining of the artery (the endothelium) grows over the metal surface of the stent.

When are stents used?
Stents are used depending on certain features of the artery blockage. This includes the size of the artery and where the blockage is. Stenting is a fairly common procedure; in fact, over 70 percent of coronary angioplasty procedures also include stenting.

What are the advantages of using a stent?
In certain patients, stents reduce the renarrowing that occurs after balloon angioplasty or other procedures that use catheters. Stents also help restore normal blood flow and keep an artery open if it’s been torn or injured by the balloon catheter.

Can stented arteries reclose?
Yes. Reclosure (restenosis) is also a problem with the stent procedure. In recent years doctors have used new types of stents called drug-eluting stents. These are coated with drugs that are slowly released and help keep the blood vessel from reclosing. Stents that are not coated with drugs are called bare metal stents. As detailed below, it is very important that patients with either type of stent take their anti-clotting medicines as directed. 

What precautions should be taken after a stent procedure?
Patients who’ve had a stent procedure must take one or more blood-thinning agents. Examples are aspirin and clopidogrel. These medications help reduce the risk of a blood clot developing in the stent and blocking the artery.  Some recent studies have suggested that blood clots may develop later on (more than a year after stent placement) in the drug-eluting stents. Therefore it is really important to stay on your medications as long as your cardiologist recommends. Aspirin is usually recommended for life, and clopidogrel is generally used for one to 12 months (depending on the type of stent) after the procedure. Clopidogrel can cause side effects, so blood tests will be done periodically. If you are taking this medication, it is important that you don’t stop taking it for any reason without consulting your cardiologist who has been treating your coronary artery disease..

For the next four weeks a magnetic resonance imaging (MRI) scan should not be done without a cardiologist’s approval. But metal detectors don’t affect the stent.

See the Related Items box above for links to the Cardiology Patient Page in Circulation, Journal of the American Heart Association:

  • Angioplasty Versus Bypass Surgery for Coronary Artery Disease
  • Restenosis: Repeat Narrowing of a Coronary Artery

Related AHA publications:

 

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2 thoughts on “Parrish Medical Center (PMC) to perform elective coronary angioplasty and stenting.

  1. In case like severely blocked heart arteries, bypass surgery produced better results. I want to know – Is bypass truly better than stenting? What do you think? I consulted about the bypass with Dr.Subash Chandra and he just said some people are afraid of the possible problems of bypass surgery so they prefer the stenting procedure. Consult him to know more about advanced surgical procedures in cardiology. Dr.Subash Chandra is a pioneer in non-coronary interventional procedures in India.

    • If I had to pick one for myself, I would go with the most minimally invasive procedure. i.e. STENTING.
      Even if I had to have it repeated, later. that is just my opinion. some people may choose surgical repair.
      Either have been shown to work.

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