"In Alabama, we have what I like to call Alabama Barbecue Disease. We have a lot of folks with calcified, challenging arteries," says Dave A. Cox, MD, interventional cardiologist and director of the Cardiac Catheterization Laboratory at Brookwood Baptist Medical Center. "You need the equipment to tackle those kind of cases."
To achieve that vision, the medical center has made a $12 million capital investment to upgrade and expand their cardiac offerings, in addition to the $10 million hybrid operating room that opened just over a year ago.
In April, Brookwood Baptist opened the next phase with a new $2 million electrophysiology lab. Renovating about 1,050 square feet, this Atrial Fibrillation (AFib) Center now utilizes the latest in Siemens equipment, including the C-arm mounted Artis zee with Pure x-imaging system.
"The technology for and the treatment of AFib has accelerated in recent years," says Russ Ronson, MD, chief of staff and director of cardiothoracic surgery at Brookwood Baptist. "AFib affects millions of Americans. With the substantial improvement in the technology, we felt that to be in the forefront of this disease, we needed the latest technology that has proven to be successful."
These advances have led to greater certainty in accessing parts of the heart, notably the left atrium. "It used to be difficult to reach the left atrium and when you got there, there was no way to find where the AFib was coming from," Ronson says. Now the newer tech lends greater definition, along with color, to the blood vessels and walls, making it safe to work in that afflicted area."
Ronson estimates that initial success rates in procedures--depending on the location of the AFib--have shot up from 40 to 60 percent to around 80 percent in certain types of AFib. "In the past, a lot of patients would need to come back for a second and third procedure," he says. "But now that is much rarer due to the technology and what we've learned about who the tech will benefit."
Next spring, Brookwood Baptist plans to unveil the final part of their major investment. Three cardiac catheterization labs will replace older ones, and include six adjacent patient prep and seven patient recovery bays, along with a registration area.
"It's been a busy cath lab, and they have served our purposes well. But with three newer labs, we can take on more challenging cases in a safer fashion--blockages that we otherwise might have shied away from because we didn't have the visualization capabilities," Cox says.
To understand the improvement in monitors in the last few years, Cox says to think of your flat-screen TV five years ago. "You can be blown away by the quality now," he says, adding that the more vibrant color on the new equipment will also up the cardiac options. "You'll be able to see the colors of the valve and what the valve is doing when you're working on it. It will be markedly improved."
Procedures, like implanting a Watchman Device to avoid clots in those diagnosed with AFib or implanting the MitraClip, a device to treat mitral valve regurgitation in patients not eligible for open-heart surgery, have become a safer option, especially for elderly patients, who Cox says will benefit the most from these advancements.
"It used to be that you would do a cath on someone at 86 in all sorts of chest pain," Cox says, because of not wanting to perform open surgery at that age. "Now we have more advanced surgeries to open up their coronary occluded vessels. We're getting more aggressive in elderly patients, that's one of the drivers for this investment."
Additional advantages of the new tech include lowering the x-ray dose needed in procedures. "That's a tremendous accomplishment," Cox says. "Any time you can do more complex cases and use a lower dose, that's safer for the patient."
So is the relocation of the new cath labs. "All of interventional cardio in our cath lab is one focused unit and will be right next to the ER," Cox says. "Heart attack patients will not have to take a long elevator ride to the cath lab. They'll go right across the hall from the ER to the cath lab. I don't think there's a hospital in Birmingham that has that."
For Ronson, the most impressive outcome of this major investment is the complete comprehensiveness for cardiac diagnosis and treatment. "From the minute you walk in, you can get everything done here," he says. "And with the availability of the newest technology, it's safer than ever before."