Hospitals Seek Approval To Provide Advanced Cardiac Care

More than 340,000 residents from greater Waterbury to Litchfield County could benefit from a proposed plan to provide advanced cardiac care in Waterbury, according to officials of Waterbury Hospital and St Mary’s Hospital in Waterbury.

The two hospitals have filed a letter of intent with the Office of Health Care access for the development of a joint cardiac program that would provide angioplasty and open-heart surgery for 20 communities, from Waterbury to Washington.

Both hospitals already offer an extensive array of acute and ambulatory cardiology services, including cardiac catheterization. The two hospitals also have the medical expertise on staff to perform angioplasty. Offering angioplasty and open-heart surgery is the next critical step in keeping the region up-to-date with accepted practice in cardiac care, according to the leaders of both hospitals.

In 2001, an estimated 1,300 individuals were referred out of the Waterbury region for angioplasty or cardiac surgery. Of that number 868 were referred for angioplasty –– a procedure in which a blocked heart artery is opened with a balloon or metal stent –– and another 431 were referred for open-heart surgery.

Those patients referred out of the area had to be transported to hospitals in Bridgeport or New Haven for advanced care, in some cases causing a delay in providing life-saving treatment.

“With a severe blockage, the longer you wait, the more heart muscle you lose,” explained Stephen Widman, MD, an interventional cardiologist on the staffs of both Waterbury hospitals.

Dr Widman, along with other Waterbury cardiologists with special training in angioplasty, must now travel several days a month to hospitals in other parts of the state to perform the procedure on their patients. “Both the patients and the doctors must leave our area to access angioplasty. This scenario puts added stress on everyone, and may lead to a less than optimum outcome,” said John Tobin, president and chief executive officer of Waterbury Hospital.

Bringing these cardiac procedures to the Waterbury region will not only benefit patients, it will reduce duplication of expensive medical care, according to the two hospital CEOs. Currently patients may undergo a diagnostic catheterization at one of the Waterbury hospitals first, followed by angioplasty once they are transferred to a facility that performance angioplasty.

“The two procedures are very much alike, except for the fact that when you are in the artery curing an angioplasty, you can fix the problem. Why put the patient through the trauma and expense of two invasive tests, when one would solve the problem effectively?” asked Dr Widman.

The cardiologist noted that the standard of care for acute coronary artery disease is rapidly evolving, from balloonlike devices to drug-eluting stents. Several studies in recent years have shown that when the drug-eluting stents are used to unblock the artery, patients suffer few instances of artery restenosis, or re-closing. Another widely used therapy in the 1990s, the use of clot-busting drugs, has also been found to be inferior to angioplasty.

The hospital must now file a Certificate of Need (CON) with the state before December 23. The CON, which is currently being developed, will include a comprehensive business plan, including the capital investments both hospitals will need to make in order to “retool” their operating rooms for open-heart surgery. The hospitals also expect to partner with another provider of open-heart surgery in order to obtain the surgical expertise required for the procedure.

Waterbury Hospital and St Mary’s Hospital have a history of collaborating on projects. In 2002 the hospitals jointly opened the Harold Leever Regional Cancer Center on the city’s west side. The Lever Center offers state-of-the-art radiation therapy, oncology services, and support services for the region.

Earlier this year, Danbury Hospital also filed a letter of intent with the Office of Health Care to provide angioplasty and open-heart surgery. Currently patients from the Danbury area also are referred to hospitals in Bridgeport and New Haven for these procedures.