NMMC heart program gets firsts

By Michaela Gibson Morris/NEMS Daily Journal

TUPELO – North Mississippi Medical Center’s Heart Institute is finishing the year with a pair of firsts.
“We have physicians who are always on the cutting edge,” said George Hand, administrator of cardiovascular services.
NMMC became the first hospital in Mississippi to perform an aortic valve replacement going through a small incision in the chest and through the bottom of the heart, instead of opening the entire chest.
NMMC was among the first eight hospitals in the nation chosen to implant a Evia HF-triple chamber cardiac resynchronization pacemaker. The device keeps the heart beating regularly, helping patients with heart failure and heart rates that are too slow.
The minimally invasive valve replacement, which uses a catheter to guide the valve into place, allows doctors to treat high-risk patients whose main artery leading out of the heart has become too narrow.
“Aortic stenosis is similar to having a kink in a water hose,” said Tupelo cardiologist Barry Bertolet. “We have to relieve that kink to keep the water – or in this case, the blood – flowing.”
Using a catheter – a specialized wire – to place heart valves without opening the chest is possible because of the installation of a hybrid operating room earlier this year and a team approach among cardiologists and heart surgeons. The hybrid OR combines imaging capabilities of a heart catheter lab with newest technology available for cardiothoracic surgery.
“Open surgery is still the treatment of choice for valve replacement,” said cardiothoracic surgeon Dr. David Talton, “but for high-risk patients – those who are older or have other serious health issues – (it) is an excellent option to extend life.”
In Feburary, the first valve replacement surgery, using the femoral artery in the leg to access the heart, was performed at NMMC. The new procedure, first performed Nov. 27, allows them to help high-risk patients who don’t have suitable arteries in their legs.
“We had a patient waiting for the procedure,” pending FDA approval and surgeon traning, said Carla Durham, cath lab manager.
The new triple chamber pacemaker is tiny, but big on technology. One of the key features is the wireless home monitoring that uses cellular networks at no cost to the patient.
“The home monitoring system is completely automated and picks up information from the patient’s implanted device and transmits it to us daily,” said Dr. Jim Stone, who is a cardiologist who specializes in the heart’s electrical system.
The data lets the clinic nurses see issues and address them before they cause noticeable symptoms, especially for heart failure patients, said Phebe Pegues, manager of the NMMC electrophysiology lab, where pacemakers are implanted.
“Those symptoms would require hospitalization,” she said.
NMMC is among prestigious company as one of the initial hospitals who began implanting the pacemaker in November; others are University of Massachusetts Medical Center, Worchester, Mass.; New York Presbyterian Hospital, Cornell, N.Y.; Walter Reed Army Medical Center, Bethesda, Md.; Spartanburg Regional Hospital, Spartanburg, N.C.; Archbishop Bergan Mercy Medical Center, Omaha, Neb.; University of Utah Medical Center, Salt Lake City, Utah; and Good Samaritan Hospital, Los Angeles, Calif.

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