New Heart Procedure
One Procedure. Many Lives Saved.
Percutaneous Coronary Intervention (PCI):
A life-saving angioplasty procedure
now available at Tift Regional Medical Center
The Georgia Department of Community Health has selected Tift Regional Medical Center (TRMC) as one of 10 Georgia hospitals to take part in a national clinical trial of a life-saving heart procedure. The three-year study plans to demonstrate, as found in other studies, that hospitals can safely perform an angioplasty procedure called Percutaneous Coronary Intervention (PCI) without having open-heart surgery as a back-up measure in case of complications.
Performed in the TRMC Heart and Vascular Center’s cardiac catheterization lab, angioplasty is a minimally-invasive stenting procedure used to unblock clogged arteries. The Georgia Department of Community Health’s clinical study will waive the state’s requirement to have an open heart surgery program at the selected hospitals during the three-year trial period.
FAQ: Frequently Asked Questions
What is PCI and how does it work?
Percutaneous Coronary Intervention (PCI) encompasses a variety of procedures used to treat patients with diseased arteries of the heart, for example, chest pain caused by a build-up of fats, cholesterol, and other substances from the blood (referred to as plaque) that can reduce blood flow, or a heart attack caused by a large blood clot that completely blocks the artery.
Typically, PCI is performed by threading a slender balloon-tipped tube – a catheter – from an artery in the groin to a trouble spot in an artery of the heart (this is referred to as percutaneous transluminal coronary angioplasty – also known as PTCA, coronary artery balloon dilation or balloon angioplasty). The balloon is then inflated, compressing the plaque and dilating (widening) the narrowed coronary artery so that blood can flow more easily. This is often accompanied by inserting an expandable metal stent. Stents are wire mesh tubes used to prop open arteries after PTCA.
For patients suffering the crushing pain of a heart attack, a lifesaving trip may be to a hospital prepared to quickly open the blocked artery by inflating a small balloon and inserting a tiny metal structure called a stent to act as permanent scaffolding. The goal: to restore blood flow to the heart muscle within 90 minutes of the patient's arrival at the hospital. Clinical studies show that patients truly benefit from a “door-to-balloon time” of 90 minutes or less. PCI done in this emergency circumstance is referred to as “primary” PCI. Other PCI procedures, such as those done to unblock an artery before a heart attack occurs, are referred to as “elective” PCI.
In the past few years, there have been dramatic advances in PCI techniques, devices, and medications. Drug-eluting stents are among the most notable. These stents not only prop open the artery, they also slowly release medication that prevents the overgrowth of scar tissue that can renarrow the artery and block blood flow to the heart, a complication known as restenosis.
What is the significance and purpose of the PCI clinical trial at TRMC?
According the Centers for Disease Control, heart disease rates in Georgia are 10 percent greater than the national average, with a high concentration of incidences occurring in counties in rural south central Georgia. Despite the wide prevalence of coronary disease, a significant number of patients in this region are not currently able to take advantage of PCI as a preventive measure.
PCI has been established as an effective procedure in reversing or minimizing hardened arteries, the cause of heart attacks and severe chest pain. The state of Georgia’s current standards have limited treatment for residents who live in rural areas, because most hospitals serving these communities don’t have on-site open heart surgery programs. With this trial, it will be proven that hospitals like Tift Regional can perform this procedure safely and effectively, like many hospitals in other states and in Europe.
Why did Georgia not allow hospitals without open-heart surgery to perform PCI?
The regulation was established many years ago in case something went wrong during the catheterization process and open heart surgery was needed. However, newer research studies have shown that clinical outcomes for elective angioplasty in programs without on-site cardiac surgery are equal to those hospitals with on-site cardiac surgery.
How did TRMC treat patients requiring PCI before the clinical study?
The TRMC Heart and Vascular Center has one of Georgia’s most advanced cardiac catheterization labs, but was not permitted to perform PCI because of state regulations. Only diagnostic cardiac catheterizations were allowed. Patients that were identified as needing angioplasty in the cardiac catheterization laboratory had to be discharged and admitted to a hospital with on-site cardiac surgery or transferred by ambulance. This created significant inconvenience for patients and their families as well as added delay, increased costs and greater health risk. And, in many cases, it was a matter of life or death.
Why was TRMC selected as one of 10 Georgia hospitals to participate in the study?
TRMC was selected to participate in the clinical study because of the hospital’s advanced cardiovascular facilities, trained staff and support from TiftCounty’s Emergency Medical Services (EMS). TRMC has one interventional cardiologist on the medical staff, Dr. Paul Murray, and one invasive cardiologist, Dr. William Hancock. TRMC is expected to perform up to 250 PCI cases per year.
Has PCI without open-heart surgery back-up been proven effective in other states?
Yes. PCI clinical trials have been conducted in other states and in Europe and has been proven safe and effective. A recent study by Johns Hopkins Hospital, reported by U.S. News & World Report and the Journal of American Medicine, followed 400 heart attack patients who were randomly sent either for clot busting drugs or angioplasty at 11 general hospitals that did not have heart surgery back-up. Six months later, the death rate among the angioplasty patients was 30 percent lower than in the clot buster group, and the rate of strokes and repeat heart attacks was 65 percent lower.
How does the PCI clinical study work at TRMC?
Patients that show indications for PCI will be educated about the clinical trial and presented a choice to have the procedure performed at TRMC or be transferred to a hospital with open-heart surgery back-up. If the patient chooses to have the procedure performed at TRMC, the patient will sign a release form. All clinical information submitted to the state is blind data and the patient’s health privacy will not be violated. As part of the state guidelines, the hospital can perform PCI on three out of every four patients requiring the procedure. For study comparisons, every fourth patient with PCI indications will automatically be transferred to a hospital with open-heart surgery back-up.
How long will the PCI clinical study last?
The clinical study is currently underway and will run for three years or until 16,000 of the procedures have been performed in the U.S., whichever comes first. When the trial is over, the Department of Community Health will evaluate the results and determine whether to change the regulations permanently, allowing the angioplasty procedures to continue.
Who are the cardiologists on the TRMC medical staff?
Paul Murray, M.D. - Affinity Health Group, 2225 Hwy 41 North, Tifton, 229-391-4100
Dr. Murray is a seasoned interventional cardiologist with special training and experience in PCI. Dr. Murray earned his medical degree from the University of Flordia and completed his residency at Georgia Baptist Medical Center. He followed with a fellowship at Wake Forest University’s Bowman Gray School of Medicine. Dr. Murray is certified by the American Board of Internal Medicine in cardiovascular diseases.
William Hancock, M.D. – Tiftarea Cardiology, 907 East 18th St, Suite 100, 229-391-9980
Dr. Hancock is a skilled and experienced invasive cardiologist who is able to perform diagnostic cardiac catheterization procedures. If PCI is indicated in a patient, Dr. Hancock would turn the procedure over to Dr. Murray. A medical graduate of the Medical College of Georgia, Dr. Hancock completed his residency and fellowship at the University of Florida. Dr. Hancock is certified by the American Board of Internal Medicine in cardiovascular diseases.
More Information
If you have any questions about PCI at Tift Regional Medical Center, please contact any of the offices of the cardiologists listed above or call the TRMC Heart and Vascular Center at 229-353-6158 or 800-648-1935, ext. 6158. Or, you may send an e-mail by clicking here.
To visit the TRMC Heart and Vascular Center webpage, please click here.
Please note: physicians are independent contractors at not employees of Tift Regional Medical Center.
|
