Modesto hospital adds more heart services. Turlock hospital changes its approach

One thing is certain, after the 20,000th open heart surgery was performed at Doctors Medical Center in June, the Modesto hospital will keep rolling out services for treating heart disease.

Doctors Medical Center has invested millions of dollars in state-of-the-art cardiac services facilities, including a new catheterization lab and a hybrid operating suite that should be completed in the summer.

Turlock’s Emanuel Medical Center, which is owned by the same parent company as Doctors, has reconsidered its cardiac services and discontinued open heart surgery. Emanuel is awaiting state approval for doing interventional cardiology procedures starting in April or May. The hospital still has emergency catheterization procedures.

Sue Micheletti, chief executive officer of Emanuel, said a hospital needs a higher volume of patients to maintain a quality heart surgery program. Centers without sufficient volume run the risk of higher-than-normal complication rates.

Emanuel had 88 open-heart surgeries in 2014, decreasing to 64 in 2015 and 32 in 2016, Micheletti said. When Tenet Healthcare Corp. purchased the former nonprofit hospital in 2014, an agreement required Tenet to keep the heart surgery program in operation for at least three years.

The hospital plans to offer cardiology interventions for lower-risk patients once it receives state approval. Tenet-owned Doctors Medical Center will remain the primary center for open heart surgeries and other cardiac services for patients coming from Modesto, Manteca, Turlock and Sonora.

Doctors now has five cath labs, identified by colors Yellow, Red, Purple ... and each is equipped with diagnostic imaging technology for viewing coronary arteries and the chambers of the heart. With the advanced technology, physicians have the tools for diagnosing disease, testing and performing complex procedures for treating irregular heartbeats, clogged arteries and valve problems.

The $5 million hybrid operating room will have advanced technology allowing doctors to perform both catheterization procedures and open heart surgeries. Dr. James MacMillan, a cardiothoracic surgeon at Doctors since 1978, will use the hybrid suite for treating coronary aneurisms.

Doctors has offered advanced cardiac services in Modesto since the 1970s and celebrated the 20,000th open heart surgery with an event at the Gallo Center for the Arts in July.

“We are the pioneers in cath procedures and open heart surgery,” said Carin Sarkis, market chief strategy officer for Doctors. “Every time there is a new advancement, we make sure we are right on the cutting edge.”

Dr. Satnam Ludder, a longtime cardiologist at Doctors, said the new catheterization lab was needed to keep up with the current volume of cases. The Florida Avenue hospital handles roughly 1,600 “caths” a year, in addition to 600 artery stenting procedures and 400 pacemaker implants. The hospital averages about 430 open-heart surgeries a year.

Ludder said the program has worked for years with the National Cardiovascular Data Registry, which uses clinical data to improve cardiovascular care.

In September, transcatheter aortic valve replacements (TAVR) debuted at the hospital for patients with severe aortic stenosis. The procedure for people who are a significant risk for open heart surgery uses a catheter inserted in the groin to replace a diseased aortic valve with an artificial one.

Without treatment, patients with severe narrowing of the heart valve have a two-year survival rate as low as 50 percent.

Dorothy Tilton, 83, of Ripon said she waited six months for a TAVR procedure, as the hospital made preparations to launch the program, because she did not want the pain of open heart surgery.

“I was getting to the point I could hardly walk across the room,” Tilton said. “I was breathing hard and was exhausted, but I held out. My husband and I wondered if I was at the start of the two years or near the end.”

Tilton and a 93-year-old man were the first TAVR cases at Doctors on Sept. 28. Following the 90-minute procedure, Tilton recovered in the hospital for two days and then returned home.

The new valve has made a world of difference, said Tilton, who enjoys shopping and going out to dinner with her husband.

Ludder said the patient in his 90s also is faring well. “We have seen him two or three times and he is happy.”

Dr. Talwinderdeep Kahlon, a cardiovascular disease specialist, said three of the valve replacements were completed at the hospital Thursday before 2 p.m. The doctors and nursing staff meet in a conference room for an hour to discuss the cases beforehand.

“There is a lot of preparation for a valve, especially,” MacMillan said. The team can’t be surprised by something going wrong, and “with a valve, the angle has to be right,” he said.

This story was originally published February 7, 2018 at 3:56 PM with the headline "Modesto hospital adds more heart services. Turlock hospital changes its approach."