Longview Hospital provides advanced bypass surgeries - KLTV.com - Tyler, Longview, Jacksonville |ETX News

Longview Hospital provides advanced bypass surgeries

Released by Longview Regional Medical Center:

LONGVIEW, TEXAS (November 12, 2010) –  When patients require medical care that is not locally available, patients and their families are faced with numerous costs and inconveniences that could be avoided closer to home. In light of this fact, Longview Regional Medical Center (LRMC) is pleased to now be offering some of the most advanced techniques for cardiovascular surgery right here in Longview. This is great news for patients since these new surgical techniques offer improved outcomes and quicker recoveries than some of the procedures that were previously the only local options.

One of the new techniques being performed is "beating heart" coronary bypass surgery for all cardiac bypass patients. In traditional bypass surgery, the patients are subjected to the heart-lung machine which involves stopping the heart, cooling the body and heart, and then re-warming the patient when the surgery is complete. During the process of attaching and being connected to the heart-lung machine, fine plaques can be dislodged into the blood circulation.  Although the machine partially filters out these plaques, a significant quantity of small plaque particles still make their way through to the patient's brain and other organs. After surgery, this can cause issues including minor brain injury and stroke. In beating heart surgery, the heart-lung machine is eliminated, and the patient stays warm throughout the surgery while the heart continues to beat. This process causes less disruption of plaque, preserves brain function, and speeds up the patient's recovery.  "It is almost like ‘Going Green' in heart surgery," says the LRMC Heart and Vascular Institute's Director of Cardiovascular Surgery, Dr. David Jayakar.

Dr. Jayakar is offering this type of surgery at Longview Regional to all bypass patients, including high risk patients. Dr. Jayakar has performed over 1500 beating heart bypass surgeries and has trained many surgeons nationally and worldwide to perform the same. "I know keeping the heart beating is best for the patient, so I am committed to offering this procedure whenever bypass is needed," says Jayakar. His extensive skill and experience with beating heart surgeries is one component of successful outcomes, but he says it is the high level of competence exhibited by the LRMC team of anesthesiologists, nurses, techs, and other staff that makes it possible for him to do this type of surgery here in Longview. "As they say, ‘it takes a village' and it really does in these cases," he says.

Dr. Stanley Tunstall, MD, is one of the anesthesiologists who has been assisting in the procedures and says he is closely involved every step along the way with these surgeries. "The anesthesiologist is always critical in bypass surgery, but with this surgery, we are right there the whole time monitoring things moment by moment throughout the surgery." Dr. Tunstall says that he sees good benefits to the beating heart surgeries, especially for patients who might not be candidates for traditional bypass surgery. "There are some patients who need bypass who probably wouldn't tolerate the process of going on the heart-lung machine, and the beating heart surgery gives those patients an option they didn't have before." Dr. Tunstall says that there are other developments at LRMC for allowing deeper breathing and reducing post-operative pain. He says part of the reason patients have reduced pain is that they are given a high thoracic epidural before the surgery to reduce the need for heavy pain medication after the surgery. This allows the patient to be alert much faster and start the recovery process much sooner. It is also a great advantage when dealing with frail patients who might be susceptible to cognitive issues related to pain medicine.

Operating room nurse Belinda Freeman, RNFA, says that she is really excited by what she is seeing with the beating heart surgeries. She says that Dr. Jayakar is doing a great job of educating both staff and patients about what to expect from the beating heart surgeries, and everyone is learning as fast as possible because they see the patients benefitting in notable ways. Freeman explains, "The patients are alert faster, experience less pain, and are able to get up and moving in about half the time we are used to. With traditional bypass surgery, we try to have the patient sitting in a chair within 24 hours, but these patients are wanting to get up and walk within 24 hours. Seeing that sort of difference in the patients is really encouraging!"

Intensive Care Unit Supervisor Sandy Brown, RN, CCRN, says that one of the biggest differences she sees in these patients is that they come out warm. "With traditional bypass, you spend a lot of time trying to get the vitals stabilized as you try to bring the patient's temperature back up from about 92 or 93 degrees to normal (98.6). With these patients already being at a normal body temperature, you eliminate a lot of the fluctuations in vital signs that happen as patients are re-warmed. There are also fewer lines going in the patient, which reduces the chance for infection, and the patients don't have to be on ventilators. Additionally, we hardly use any blood products with these patients, and in the rare instance when we do, we can use the patient's own blood. All of these differences add up to huge benefits for the patient, so I am really impressed with the speed of recovery after beating heart surgery."

Mrs. Brown also notes that since Dr. Jayakar is able to do these surgeries using a smaller incision through the sternum, the patients are often driving within a week after their surgery. With traditional bypass where the sternum is fully opened, the recovery from the disturbance to the chest often means that the patient cannot drive for six or eight weeks. She says the faster people can get back to normal activities, the better off they will be in the long run. She adds that Dr. Jayakar ensures that every person involved in the care of these patients is extensively educated on how to care for these patients and constantly tells them how much he values nursing as a critical component of successful patient outcomes.

To learn more about the cardiac care services at Longview Regional Medical Center and The Heart & Vascular Institute of Longview Regional visit www.longviewregional.com. LRMC is proud of the quality care we deliver to the residents of our community and our surrounding area. And we are certainly proud to lead many other hospitals, both nationally and locally, in the cardiovascular process of care measures monitored by the Centers for Medicare and Medicaid Services (CMS).* So when you need quality care, choose the hospital that ranks highest in all Care Measures in Longview. To learn more, visit Medicare's Web site,

www.hospitalcompare.hhs.gov. Or visit our Web site, www.longviewregional.com/compare for more information.


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