Advancement in heart treatment available close to home.

At the Heart of a Community

NORTH MISSISSIPPI MEDICAL CENTER'S TOP-RATED CARDIOVASCULAR PROGRAM did not just develop in a heartbeat. Becoming the region's leader in heart care has been a distinction more than 20 years in the making.

It began with Max Hutchinson, M.D. Two years after joining the NMMC medical staff as a general surgeon, Dr. Hutchinson had the opportunity for additional training in cardiothoracic surgery at the Medical College of Georgia in Augusta.

He returned to Tupelo and, in January 1981, performed NMMC's first heart bypass surgery. The following month he completed the hospital's first heart valve replacement surgery.

"We believed our heart program was off to a remarkable start in 1981 when we performed 148 open heart surgeries," Dr. Hutchinson says.

So remarkable, in fact, that a second cardiothoracic surgeon, H. Pat Ewing, M.D., was recruited to NMMC in 1983. The duo performed their 1,000th open heart surgery in March 1986, a mere five years after the first case.

And the program continues to grow. Cardiothoracic surgeon Kenn Beeman, M.D., joined the medical staff in 1992. David Talton, M.D., came on board in 1997, followed in 2000 by Vishal Sachdev, M.D. A sixth cardiothoracic surgeon, Robert J. Derveloy M.D., joined the group in 2003.

"Now we are up to 1,000 heart bypass and valve surgeries a year," Dr. Hutchinson said. "We're serving more patients than I ever expected 20 years ago."

At the Heart of Advancement

Not only is the local heart surgery program growing in volume, but also in capabilities.

Transmyocardial Revascularization

In 1999, NMMC became one of only two hospitals statewide to offer transmyocardial revascularization, a procedure that involves drilling tiny holes into the heart with a laser to relieve angina pain.

Homograft Valves

NMMC's cardiothoracic surgeons were also among the first to use homograft heart valves to replace a person's own damaged or diseased heart valves. Homograft valves are crafted from human tissue and offer a more natural approach to heart valve replacement surgery.

"Off-pump" Bypass Surgery

"In 2000, our hospital pioneered 'off-pump' or 'beating heart' bypass surgery," Dr. Talton says. "Off-pump bypass surgery allows us to perform the surgery without stopping the heart and temporarily replacing its functions with the heart-lung machine. As a result, patients often experience shorter hospital stays, a faster recovery period and less blood loss."

Surgical Ventricular Restoration

In 2001, NMMC introduced surgical ventricular restoration (SVR), a new surgery for correcting the enlarged, poor functioning left ventricle common in congestive heart failure patients. A specialized implant guards against leaking and helps restore the left ventricle. "With SVR, we can treat the cause of the heart failure, not just the symptoms," Dr. Sachdev says. "This new technology vastly improves the quality of life for these patients, as well as reduces the chance of repeated hospitalizations for heart failure."

Atrial Fibrillation Procedure

Another breakthrough came in 2002 with enhancements to a procedure for treating atrial fibrillation, an irregular heartbeat in which the two upper chambers of the heart quiver instead of beating effectively.

"For the past 20 years, the traditional surgery for atrial fibrillation has been the maze procedure, so called because it involves cutting and suturing a maze of incisions in the heart," Dr. Talton says. "When the incisions heal, scar tissue forms and prevents the abnormal electrical impulses from passing through the heart. Essentially, the maze procedure creates barriers that the electrical impulses cannot cross."

The problem, Dr Talton explains, was the time it took, as well as excessive bleeding and potential complications "We now do the maze procedure with an innovative, pen-like device that allows us to 'draw' over the targeted tissue using radiofrequency energy to ablate. or vaporize, the cells causing troublesome electrical activity," he says. "The pen allows us to 'draw' the lines that create scar tissue, rather than actually cutting and suturing the heart."

Biventricular Assist Device

NMMC is one of only two hospitals in Mississippi to offer the biventricular assist device, technology that simulates the heart's own pumping capability. "We can surgically implant this mechanical pump type device in patients whose heart continues to fail," Dr. Talton says "The biventricular assist device is often referred to as a bridge to transplant' because it can sustain a patient's weakened heart while waiting for a transplant."

At the Heart of Leadership

To accommodate the increasing number and complexity of cases, in 2003 NMMC built four new operating rooms exclusively for heart surgeries. The hospital also added six beds in the surgery recovery area and replaced the 36 bed ICU with a 50-bed critical care unit.

The cardiothoracic surgeons are quick to point out that the program's success is directly related to a commitment to be the best. "NMMC has become a heart referral center." Dr. Talton says. "People with complex heart problems are referred here, not out of town or out of state."

its heart program has helped the local hospital attract national attention. NMMC has been recognized as one of the top 100 cardiovascular hospitals in the nation. The ranking, released by Solucient, a health care consulting company that has conducted these evaluations since 1993, examined hospitals Hint perform a large number of cardiovascular procedures.

In other grading scales, NMMC also ranks among the best in the state on outcomes among patients who have heart bypass surgery.

"NMMC has brought big-city heart treatment options to Tupelo," Dr Talton says. "We are achieving phenomenal results."

NMMC's HEART INSTITUTE, located on the second and third floors of the East Tower, is home to four state-of-the-art cardiac catheterization labs, as well as labs for echocardiography, electrophysiology and nuclear studies. The Heart Institute offers advanced cardiac treatment procedures such as balloon dilation, stent implantation, pacemakers, atherectomy, valve replacement and open heart surgery,

The Heart Institute also offers cardiopulmonary rehabilitation services to help patients rebound physically and emotionally from cardiac and lung disease.

Pediatric cardiologists affiliated with Le Bonheur Children's Medical Center in Memphis see pediatric patients weekly at NMMC's Heart Institute by physician referral.

For more information on services available through the NMMC Heart Institute, call 1-800-THE DESK (1-800-843-3375).