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Beebe Medical Center, partnering with Christiana Care Health System in Wilmington, will bring advanced cardiac surgery to its Lewes campus by the end of 2005, under an agreement signed this week by officials of both hospitals.
“Through this affiliation with a quality heart surgery program such as Christiana Care, people in Sussex County who need heart surgery will have the safety and convenience of having heart surgery near their homes,” said Jeffrey Fried, Beebe Medical Center president. “In addition, people who need interventional heart procedures, such as balloon angioplasty or stent placements, will be able to have those services at Beebe Medical Center.”
Fried said Beebe considered setting up a cardiac surgery center on its own. “But we felt that affiliating with a first-class program like Christiana’s would give us and our staff a head start in terms of training and quality. Quality is our overall concern, and we feel this partnership best meets that need.”
According to Beebe’s chief cardiologist, Dr. Alberto Rosa, offering interventional cardiology and open-heart surgery will take Beebe into a higher realm of cardiac medicine.
“It’s like moving from short pants into long pants,” Rosa said. “This will impact every other aspect of care at Beebe at every level of service. An open-heart program demands a series of supporting services that must be kept up to speed to support the program.”
Rosa also said the program will involve significant participation by the community to maintain the program. People will need to contribute. We know however that the people who demand these services are moving to the area and would prefer to have their needs met locally rather than having to drive to Salisbury or Wilmington.”
Fried said Christiana Care will provide the heart surgeons for Beebe’s program. “A resident heart surgeon will be employed by Christiana to live here and work at Beebe and be available for open heart surgery around the clock. We will be completely self-sufficient. Of course Christiana’s other heart surgeons will also be available through our affiliation.” Fried added that the affiliation with Christiana Care for heart surgery was a natural one to pursue. “We already work with them on our cancer program and that has proven very successful.”
Beebe Medical Center’s board of directors earlier this year authorized the administration to prepare a bond issue to generate more than $6 million for the new program, which was officially signed this week by Fried and Christiana President Robert J. Laskowski.
The money will be used to add two new cardiovascular operating rooms and an additional catheterization laboratory. The new facilities will be provided through renovations on the surgery floor of Beebe’s medical complex in Lewes. Operating rooms for open heart surgery and interventional cardiology must be considerably larger than current operating rooms because of the extensive array of equipment needed and a greater number of doctors and nurses working simultaneously.
Interventional cardiology involves such procedures as placement of stents in blood vessels and angioplasty. Stents are very small tubes deployed in blood vessels to open areas that catheterization shows have been restricted by the action of heart disease. Drug-eluting stents –increasingly popular for treating blockages - are stents impregnated with drugs that help prevent continued growth of material that can block vessels.
Angioplasty is a procedure that uses small, balloon-like devices to open vessels in which disease has restricted the normal flow of blood. Physicians place stents and perform angioplasties in an interventional cardiology procedure that involves a small flexible wire inserted into arteries and fed toward problem areas identified through the catheterization diagnostic process.
Open heart surgery procedures that Beebe plans to offer include coronary artery bypass grafts and valve repair and replacement.
“Technological advancement has enabled hospitals like Beebe to offer services like these,” said Dr. Rosa. “People shouldn’t be surprised that we’re not a 10-story building on 200 acres. This doesn’t require that. We plan to begin with state-of-the-art technology and build our program from there.”
Although Beebe Medical Center currently has the cardiologists and facilities to deploy stents and perform angioplasty in its catheterization laboratory, state law requires that open heart surgery facilities be available where such services are performed in the event that complications arise.
Donna Streletzky, Beebe’s vice president of operations, said studies show that a facility with open heart services needs to perform at least 200 surgeries per year to keep its skill levels sharp. “Our cardiologists are already referring out 300 cases per year which could involve such surgeries. We will be ramping up over the next few years but by year three or four we expect to be at that 200-caseload level needed for a mature program.”
Rosa said there are approximately five to six drug-eluting stent procedures for each open heart surgery case per year, on average. In addition, he said Beebe cardiologists currently perform about 600 diagnostic catheterizations each year without any interventional procedures. With interventional cardiology available, said Dr. Rosa, diagnostic cases at Beebe should at least double.
“We also know that people prefer not to travel elsewhere if the facilities and services are available here,” said Streletzky. She said Beebe’s emergency department annually transfers out about 360 cases related to cardiac matters.
Wally Hudson, vice president of corporate affairs at Beebe, said the addition of interventional cardiology and open heart surgery will result in many new jobs for the area in critical care, intensive care, nursing and cardiology. He said research indicates the necessary personnel will be available for the positions.
Beebe Medical Center isn’t the only regional facility adding interventional cardiology and open heart surgey. Bayhealth Medical Center announced last year that it has formed a partnership with University of Pennsylvania Health System to bring those services to its Kent General facilities in Dover. Bayhealth recently announced the medical team that will occupy new facilities being prepared for the services. Beebe officials said Bayhealth’s plans won’t affect Beebe’s plans. “Our research indicates to us that our growing population will support the interventional cardiology and open heart surgery we are planning here,” said Hudson.
Fried said the steady movement of outpatient surgery procedures to Beebe’s Route 24 health campus is also helping to free space at the Lewes campus for the next stage of Beebe’s development as a medical institution
“This is another extension of bringing tertiary cardiac procedures to community hospitals,” said Dr. Rosa. “The fourth level is transplants and they won’t be done here. But we always want to be positioned to bring technology advances to the community.”
Beebe Medical Center has a long history of providing non-invasive diagnostic cardiology services; however, the scope of heart services at Beebe increased dramatically in 1998 with the opening of Beebe’s first cardiac catheterization laboratory for diagnosing heart disease. Fried and Laskowski said the two health systems are working closely to establish a cardiac surgery program at Beebe that combines the experience, technology and successful outcomes gained from Christiana Care’s 19-year impressive history in heart surgery with local convenience for Sussex County residents.
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