Michael E. DeBakey VA Medical Center - Houston, Texas
"Door to Balloon" Time Can Save Lives; Houston VA Averages Quick 61 Minutes
August 19, 2010
The Heart Attack Team at the Michael E. DeBakey VA Medical Center - Front row from left: Aleyamma George, R.N.; Lucy Lacy, R.N.; Lisa McGowan, R.N.; and Susan Ninan, R.N. Middle row: Hani Jneid, M.D.; Biswajit Kar, M.D.; Mariamma George, R.N.; Sajimon Chacko, R.N.; and Cheryl Duncan, R.N. Back row: Celso De Los Santos, R.T. and Renato Flores, R.N. Not pictured: David Paniagua, M.D.; Martin Rodriguez, R.T.; Jebbeh Sandi-McBean, R.N.; and Ellen Karisch, R.N..
HOUSTON – The "Heart Attack Team" at the Michael E. DeBakey VA Medical Center is on-call 24 hours, seven days a week, ready to report immediately to duty when a patient arrives at the VA in cardiac distress. This team of physicians and nurses prepares the Cardiac Catheterization Laboratory to receive a patient for treatment by balloon angioplasty or stent.
"Patients are taken directly to the Cardiac Catheterization Lab, after rapid evaluation in the Emergency Room, for percutaneous coronary procedures to restore blood flow to the heart,” said Biykem Bozkurt, M.D., Cardiology chief. “The goal of the team and this effort is to provide treatment as quickly as possible, within 90 minutes of a patient’s arrival."
In Fiscal Year 2008, the average “Door to Balloon” time at the MEDVAMC was 82 minutes. A year later, the staff improved the time to 61 minutes. The American College of Cardiology and the American Heart Association have developed national guidelines calling for a door-to-balloon time of less than 90 minutes for hospitals that offer direct angioplasty.
“We advise people to call 911 or get to a hospital immediately if they experience chest pressure or pain in the center of their chest. Especially, if this is accompanied by pain or discomfort in one or both arms, back, neck jaw, or stomach; shortness of breath; or sweating, nausea, or lightheadedness,” said Biswajit Kar, M.D., Interventional Cardiology director.
Performed by interventional cardiologists, a balloon angioplasty opens a patient’s narrowed arteries using a long, thin tube with a small balloon on its tip. The balloon is inflated at the blockage site in the artery to flatten or compress plaque against the artery wall.
The war has presented numbers and types of injuries that could not be predicted when it began. But VA adapted as quickly as possible. Some examples.
Subsequently, in most cases, a coronary stent is also inserted. A stent is a small, mesh-like device made of metal. When a stent is placed inside of a coronary artery, it acts as a support or scaffold, keeping the vessel open. By keeping the vessel open, the stent helps to improve blood flow to the heart muscle.
"Cardiologists always say ‘Time is Muscle.’ Every minute matters when a patient is having a heart attack,” said Blase A. Carabello, M.D., Medical Care Line executive. “Swift treatment is important to improve a patient’s chance of survival and minimize damage to the heart by quickly restoring blood flow to the heart."
In addition, all Veterans are screened for depression at the VA. Those in emotional crisis can be admitted immediately. To meet the growing workload, almost 100 mental health providers have been added to VA operations in southeast Texas since 2005. The DeBakey VA opened two new nursing units in 2009 to provide specialized inpatient mental health services for returning combat troops and for women Veterans”
The MEDVAMC already recognized for demonstrating consistently low observed-to-expected mortality rates in general surgery, all surgery, and all non-cardiac surgery nine years straight, continues to raise the bar and improve treatments and outcomes for Veterans who suffer heart attacks.
Awarded the Robert W. Carey Circle of Excellence Quality Award in 2007 and re-designation for Magnet Recognition for Excellence in Nursing Services in 2008, the Michael E. DeBakey VA Medical Center serves as the primary health care provider for more than 120,000 veterans in southeast Texas. Veterans from around the country are referred to the MEDVAMC for specialized diagnostic care, radiation therapy, surgery, and medical treatment including cardiovascular surgery, gastrointestinal endoscopy, nuclear medicine, ophthalmology, and treatment of spinal cord injury and diseases. The MEDVAMC is home to a Post Traumatic Stress Disorder Clinic; a Network Polytrauma Center; an award-winning Cardiac and General Surgery Program; a Liver Transplant Center; a VA Epilepsy Center of Excellence; a Health Services Research & Development Center of Excellence; a VA Rehabilitation Research of Excellence focusing on mild to moderate traumatic brain injury; and one of the VA’s six Parkinson’s Disease Research, Education, and Clinical Centers. Including the outpatient clinics in Beaumont, Conroe, Lufkin, Galveston, and Texas City, MEDVAMC outpatient clinics logged almost one million outpatient visits in fiscal year 2009. For the latest news releases and information about the MEDVAMC, visit www.houston.va.gov.