Heart center makes itself known

North Idaho’s first heart program has surpassed national success rates in its inaugural year, but many patients from Idaho’s five northernmost counties continue to travel to Spokane for open heart surgery or catheterization procedures.

Short of hanging a “We’re safe, really!” banner from the North Idaho Heart Center’s new $9.6 million, three-story building at the Kootenai Medical Center in Coeur d’Alene, an effort is under way to persuade patients to stay close to home for heart procedures.

“There’s still a watch-and-wait mentality,” said Dr. Rob Burnett, the program’s founding cardio-thoracic surgeon. “This goes for physicians as well as patients.”

Burnett and interventional cardiologist Dr. Dennis Cooke have been meeting with health care providers across North Idaho to spread the word about the program. They’re sharing outcome data from the program’s first year in hopes of building patient confidence and adding physician referrals.

“It’s not to say that we’re better,” Burnett said. “It’s to say we’re doing it as well as anyplace else. We’re very proud of our results.”

Since the program began in September 2003, there has been only one death out of the 145 open-heart surgeries performed, which is well below the 2.6 percent national mortality rate for bypass operations not involving valve repairs, Burnett said. The heart center also has had no instances of other post-operative plagues: kidney failure, heart attacks or significant neurological problems.

Also in the first year, more than 1,000 clogged blood vessels have been diagnosed or opened up using catheters. There have been no deaths in the catheterization labs and only one case of a death following a procedure. The case involved a patient who had arrived at the lab with considerable tissue damage from a heart attack, Cooke said.

Another important measure of performance is the time between a heart attack patient’s arrival at the hospital to the time when the clogged vessel is opened, Cooke said. The national goal is 90 minutes. The North Idaho Heart Center has been averaging in the “high 70 minutes” range, Cooke said.

Both Cooke and Burnett said it’s impossible to know if any lives have been saved because of the new program. But with heart attacks, treatment delayed can cause irreparable harm. “The one thing we know is the sooner we deal with them, the better the outcome,” Cooke said.

One factor in the success has been careful selection of the program’s earliest patients. The most complicated cases are sent to Spokane, which has a nationally renowned heart program, including the ability to conduct heart transplants and complicated electro-physiological procedures. Burnett estimated that fewer than 5 percent of his patients need surgery in Spokane and the number continues to drop.

“We’ve increased our degree of difficulty significantly,” Burnett said.

An estimated 350 North Idaho residents need open-heart surgery each year, according to information from Kootenai Medical Center. This represents nearly $40 million in potential revenue during a time of increasingly fierce competition between health care providers. Another 2,000 North Idaho residents’ heart problems are diagnosed or fixed using wire catheters.

In comparison, Spokane’s Sacred Heart Medical Center performs about 1,500 open heart surgeries annually, hospital spokeswoman Maureen Goins said in a December interview. Hospital officials were unavailable for comment Friday. Previously, the hospital has pointed out that higher-volume heart programs have lower mortality and morbidity rates, according to national studies.

Although KMC’s program is relatively small, both Cooke and Burnett say they are busier than most of their colleagues in large cities. “We’re very high-volume operators,” said Cooke, senior partner in the Spokane-based Heart Clinics Northwest practice. “My volumes doubled when I came here.”

Measurable indicators of success are important, Burnett said, but for most patients only one thing matters: “People like to be close to home.”