Sutter Roseville Medical Center – whose doctors each perform 150 angioplasty and stenting procedures a year – wants to be designated as a "heart attack center" as part of a state experimental program.
The state health department later this year will pick six hospitals for the pilot program to offer both kinds of procedures without on-site cardiac surgery services.
"With heart attacks, the first 90 minutes are crucial," said Dr. George Fehrenbacher, Sutter's chief of staff. "You want to give (people) the best chance possible."
If Sutter Roseville is picked for the program, patients who are experiencing heart-attack symptoms would be taken directly there instead of to nearby emergency rooms. Once there, they could undergo angioplasty and stenting procedures.
An angioplasty is a common heart procedure typically performed by threading a slim balloon-tipped catheter from an artery in the groin to the problematic region of a cardiac artery.
The balloon at the tip of the catheter is then inflated, compressing the plaque and opening up the narrowed coronary artery so that blood can flow more easily.
This is often accompanied by insertion of an expandable metal stent – a wire mesh tube used to prop open arteries and keep them open.
Designating heart attack centers that don't have full cardiac surgery backup on site is somewhat controversial.
Some suggest that only high-volume cardiac specialists – those who do 100 interventions a year – with meticulous track records should consider performing the coronary procedures without a surgical safety net.
Sutter and other hospitals fought for a statewide trial of the program for more than three years, saying that having a designated cardiac treatment center that can operate 24 hours a day and 365 days per year is key to improving patient care.
"When a person is having a heart attack, it's very important to open up a blocked artery as quickly as possible," said Fehrenbacher, who is also Sutter Roseville's co-medical director of cardiology. "In order to reduce it to its normal rate, you need to have very fast availability to performing stents. If there's a designated heart attack center, we can do that."
So far, 28 states allow both elective and emergency coronary interventions to be performed without surgical backup. Seven states – Arkansas, Delaware, Mississippi, North Dakota, South Dakota, Wyoming and Vermont – prohibit this practice.
Sutter Roseville physicians say the program would save lives.
"Three years ago, it was a more controversial subject," Fehrenbacher said. "But more recently, the data has been overwhelmingly supportive of performing this procedure in facilities that have a quality program.
"There is no mortality difference or disadvantage to doing this," he said, "as long as there is good quality review, measuring all of our outcomes."
Call The Bee's Marissa Lang, (916) 321-1087.
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