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Medford Transcript
October 26, 2006
By Carly Okyle
Although they’ve been waiting for more than a decade, physicians and staff at Melrose-Wakefield Hospital have not weakened
in their desire to perform elective angioplasty procedures onsite, even if it costs a few hundred thousand dollars.
 | Hallmark Health’s Melrose-Wakefield Hospital
was recently picked as one of seven area
facilities to participate in an angioplasty trial.
Although the hospital has had a cath lab since
1993, it was used as a research facility.
(Courtesy) |
"It’s a major investment for our organization, but we feel strongly that it’s best for
the community," said Steven Kapfhammer, executive vice president of the
hospital.
There has been a cardiac catheterization lab in the hospital since 1993, but until
September, it was used as a research facility. But it seems as if Hallmark Health’s
investment is about to pay off.
The Department of Public Health recently granted Melrose-Wakefield Hospital
permission to perform elective angioplasty procedures as part of a trial which
compares coronary intervention between Massachusetts hospitals with cardiac
surgery on the premises and community hospitals without the service. The trial is
designed to look at 6,000 patients and will take approximately four years to
complete.
Kapfhammer is anticipating 100 elective angioplasty procedures to be performed in this
coming year.
"The physicians and staff are committed to the success of the initiative," Kapfhammer said.
 | Interventional cardiologist, Laurence
Conway, MD, left, Elaine Gale,
Hallmark Health director or cardiac
and endovascular services, and
Steven Kapfhammer, executive vice
president, Melrose-Wakefield
Hospital, in the cardiac
catheterization lab at Melrose-
Wakefield Hospital. (Courtesy) |
Kapfhammer also explained the difference between the two procedures. In an emergent
angioplasty, the patient is brought in by an ambulance and is in the middle of experiencing
cardiac arrest when he or she reaches the hospital. Melrose-Wakefield has been performing
around 40 emergent procedures per year since 2004.
Due to a high success rate with the practice and a door-to-balloon time that was below the
national average - about 93 minutes compared to 155 minutes - the hospital was selected to
participate in the trial, which focuses on angioplasties performed prior to a heart attack,
called elective angioplasties.
In both procedures, a balloon is inserted into an artery and then expanded so that the artery
widens to allow blood to flow to the heart after a clot is removed. Then, a metal stent is
inserted to keep the artery from either narrowing
again or collapsing. The entire process takes an hour and a half.
The process of an elective angioplasty comes with a low complication rate, but the
hospital has protocols in place in case difficulties arise. In such a situation, the patient
would receive care from Mass General Hospital, which performs open-heart surgery.
 | Cardiac catheterization nurses Ron
Mendes, RN, left, and Linda McCabe,
RN, with Bruce Watrous, MD, an
interventional cardiologist, and Laurence
Conway, MD in the cardiac
catheterization lab at Melrose-Wakefield
Hospital. (Courtesy) |
However, if Melrose-Wakefield can prove that it can perform the elected procedures
just as safely onsite as at a tertiary facility - which Kapfhammer hopes this trial will
show - it would be beneficial to the community, saving residents the time and money
it would take to travel into Boston.
"The patients want it done here because they’re comfortable here," Kapfhammer said.
"We offer outstanding quality care in a community setting."
Currently, the hospital has the distinction of being the only community hospital to
offer both types of angioplasties.
"We have high quality lab, physicians and staff who are dedicated and concerned
about their patients being cared for appropriately," said Kapfhammer. "They [want]
access to [elective angioplasties] to make sure that we can meet the needs of the community in which we serve."
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