For Immediate Release

January 13, 2004

Oklahoma Heart Hospital Leads Nation

Oklahoma City—The Oklahoma Heart Hospital is ranked in the top 1 percent nationally for patient satisfaction, and more than 1,100 heart surgeries were performed at the nation’s first all-digital hospital this past year.

For patients, that means better outcomes. According to the American Heart Association’s Circulation journal, as well as The New England Journal of Medicine, numerous studies show that the more procedures physicians do, the higher the success rates.

The Journal of the American Medical Association specifically states that “empirical evidence suggests that mortality rates for coronary artery bypass graft (CABG) surgery are lower in hospitals that perform a higher volume of the procedure…Higher-volume hospitals also had shorter average postoperative lengths of stay and fewer patients with extremely long stays.” Data over the past decade has continued to echo the finding that hospitals performing higher numbers of procedures have lower complication and mortality rates.

“We are performing more heart surgeries per surgeon than facilities such as Cleveland Clinic and Mayo Clinic,” said Dr. Scott Lucas, an Oklahoma Cardiovascular Associates (OCA) and Oklahoma Heart Hospital cardiothoracic surgeon. According to 2002 Cleveland Clinic Foundation data, 14 surgeons at the Cleveland campus performed 3,825 surgery procedures (an average of 273 per surgeon in a year). With more than 1,100 performed this past year at the Oklahoma Heart Hospital, the average per surgeon is 366. In addition, Mayo Clinic has nine surgeons and performs about 2,500 heart surgeries every year (an average of 277 per surgeon).

“With Oklahoma ranking second in the nation in deaths due to cardiovascular disease, the need for the Oklahoma Heart Hospital is long overdue,” said Dr. Mark Bodenhamer, a member of OCA—the largest group of cardiovascular physicians in the state. “Here, our primary focus is hearts. We want to care for patients with heart problems and help educate them about living a heart-healthy life.”

Dr. Bodenhamer, Dr. Lucas and Dr. John Randolph—all OCA and Oklahoma Heart Hospital cardiothoracic surgeons with Oklahoma roots—together provide Oklahomans with the latest heart procedures. In the upcoming 2004 Society of Thoracic Surgeons conference—one of the two leading surgery conferences held annually—the focus will be arrhythmia surgery, cardiac ventricular remodeling surgery and Transmyocardial Revascularization (TMR)—all procedures performed at the Oklahoma Heart Hospital.

“We are providing Oklahomans with the newest advancements in heart care,” said Dr. Randolph. “Oklahoma has it all right here at the Oklahoma Heart Hospital.”

Oklahoma Heart Hospital cardiac surgeons were recently trained and have already performed a procedure using a new device—the Cardioblate BP Surgical Ablation System—to treat heart arrhythmias, particularly atrial fibrillation. Patients who have atrial fibrillation suffer an increasingly diminished quality of life and higher risk of stroke. Instead of using the standard Maze procedure, where cardiac tissue is cut to create cell death, then sewn back together, the Cardioblate system kills cells by using irrigated radio frequency. “Both procedures create cell death along the pathway to control the direction of the electrical current and return the patient to normal sinus rhythms,” said Dr. Randolph. “But with the Cardioblate, you aren’t cutting tissue which is very difficult to put back together. It means less time in surgery and fewer complications for the patient.”

“Without new technology such as Cardioblate and the standard Maze procedure, patients have three options,” said Dr. Bodenhamer. “They can wait and see if the arrhythmias convert back to a normal sinus rhythm, take medication or undergo shock therapy. By staying trained in the latest procedures, we offer Oklahomans better care. We provide them with the most up-to-date technology.”

The Oklahoma Heart Hospital also offers cardiac ventricular remodeling surgery. In recent months, Dr. Lucas—the only surgeon in the state currently trained in this procedure—has performed a half dozen of these heart-remodeling procedures. By cutting away a portion of the heart, Dr. Lucas reduces a patient’s enlarged heart to a more normal size and shape.

“Shrinking the size of the heart allows it to work more efficiently and increases the amount of blood it can pump through the body with each beat,” said Dr. Lucas. “As a patient’s heart gets smaller, it becomes stronger.”

The treatment was pioneered more than a decade ago in Brazil as a possible alternative to a heart transplant. “This is without a doubt a viable option to a transplant when ischemic disease is involved,” said Dr. Lucas. “The outcomes are very encouraging.”

Another new surgical procedure available at the Oklahoma Heart Hospital is Transmyocardial Revascularization (TMR). Lasers create small channels in the heart muscle to trigger the creation of new blood vessels in the heart to relieve angina pain. In the November 2003 session of the American Heart Association, data from a five-year study showed that patients who underwent TMR had a better survival rate (65 percent at five years) than patients who received drug therapy (52 percent). In addition, 33 percent of TMR patients compared to 11 percent of medically managed patients were completely free of angina pain after five years.

With some 7 million angina sufferers in the United States alone, TMR is an option for those patients with advanced coronary artery disease and disabling angina. “The data leaves little doubt that no-option, class IV angina patients can receive significant relief from TMR,” said Dr. Randolph. “This five-year study represents a significant advance in therapy for this form of heart disease—a condition that is often frustrating for both the physician and the patient if left untreated. Now, we can do something for our patients with severe angina pain.”

Together, Drs. Bodenhamer, Lucas and Randolph provide Oklahomans with surgery care that rivals the nation’s leading institutions. Not only do they practice in Oklahoma, Drs. Bodenhamer and Randolph were born in Oklahoma while Dr. Lucas moved with his family to Oklahoma when he was 5-years-old. All three received their medical degrees from the University of Oklahoma. Like many physicians with Oklahoma Cardiovascular Associates who make routine visits across the state, these Oklahoma Heart Hospital surgeons are dedicated to providing heart care to all Oklahomans. Dr. Randolph, born and raised in Seminole, sees patients monthly in Ada, Ardmore and Seminole.

By staying trained in the newest heart procedures and outperforming other area hospitals with double the heart procedures, patients won’t find better care anywhere.

“For a 78-bed hospital, we do a phenomenal number of heart surgeries,” said Dr. Bodenhamer. “We are among the nation’s leaders.”

More About Oklahoma Heart Hospital
Besides possessing a surgery team that rivals any in the nation, the Oklahoma Heart Hospital also boasts the following:

• First all-digital hospital in the nation

• Listed in top 1 percent of patient satisfaction in the country, according to Press Ganey Associates—the health care community’s top satisfaction measurement and improvement firm. The number reflects participation of 833 hospitals and a half million patients nationwide.

• 1:4 nurse to patient ratio on the floors; 1:2 and 1:1 in Critical Care Unit; 1:1 for heart recovery

• Average length of stay for surgery patient is 3.25 days

• Cardiac surgery infection rate below national average

• Cardiac surgery acute care mortality rate below national average

• 45 minutes from ER to surgery in contrast to national average of two hours

Surgery Procedures Available at Oklahoma Heart Hospital

Valve Surgery

• Replacement

• Repair

• Ross Procedure

Coronary Artery Bypass Graft (CABG) Surgery

• Off-pump

• On-pump

Arrhythmia Surgery

• Atrial Fibrillation (Cardioblate)

Transmyocardial Revascularization (TMR)

Ventricle Remodeling Surgery

Valve Surgery
Depending on a patient’s health, one of three valve surgeries (replacement, repair or the Ross Procedure) may be required. More people require valve surgery than any other kind of heart surgery, and surgeons at the Oklahoma Heart Hospital perform more valve repairs than any other facility in the state. “Repair is the best case scenario for mitral valves,” says Dr. Lucas. “If you can repair a valve, the heart function is better long term, and patients don’t have to take blood thinners the rest of their lives. It’s more difficult to do, but it’s better for patients.” Valve repair, versus valve replacement, also significantly lowers the risk of stroke. According to the University of Maryland, the mortality rate for a repair is 1 to 2 percent versus 6 to 8 percent for replacement.

In some cases, valves can’t be repaired and surgeons must replace a diseased or damaged valve with either a biological or a mechanical valve, such as a manufactured prosthesis. Another option at the Oklahoma Heart Hospital is the Ross Procedure. A patient’s diseased aortic valve is replaced with the patient’s healthy pulmonic valve. During the same surgery, the pulmonic valve is replaced with a healthy valve from a deceased human donor. With a success rate of more than 90 percent, the Ross Procedure also requires no anticoagulation therapy.

Off-Pump Bypass Surgery
Although not all patients are candidates for off-pump bypass surgery, some research suggests that patients tend to have fewer complications if they aren’t placed on a heart-lung machine during open-heart surgery. Dr. Bodenhamer, who performs off-pump bypasses on about 75 percent of his patients, leads the state in off-pump bypasses. According to the Cleveland Clinic, off-pump bypass surgery is used in about 30 percent of patients nationwide.

At the Oklahoma Heart Hospital, all three surgeons perform off-pump bypasses. Rather than stopping the heart, technological advances and new kinds of operating equipment now allow surgeons to stabilize portions of the heart during surgery. Studies have shown that the benefits of off-pump surgery include shorter hospital and recovery time, less bleeding, less potential for infection and less trauma. Whether on-pump or off-pump, coronary bypass operations have excellent results with a very low risk of death, stroke or myocardial infarction.

Oklahoma Heart Hospital also offers endoscopic vein harvesting on all bypass patients, resulting in fewer complications and less discomfort for patients. “We also have the ability now to attach vein grafts to the aorta without placing any clamps on the aorta,” says Dr. Bodenhamer. “This is critical because clamping the aorta has always been known to potentially cause strokes during heart surgery.”

Oklahoma Heart Hospital, the first all-digital hospital in the nation, is a partnership between Oklahoma Cardiovascular Associates and Mercy Health Center, along with other cardiovascular physicians.
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