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basis so they do not feel like they are are part of an assembly line process."
Prairie Heart Institute is one of the largest heart centers in the nation. It performs about 1,500
open-heart procedures, 1,300 other cardiac surgeries and 10,000 cardiac catheterizations annually.
In 1996, PHI performed its first heart transplant. In 2002, Prairie surgeons surgically implanted
the first
bi-ventricular pacemaker and defibrillator for the treatment of advanced congestive heart failure.
"In patients who were found to need some sort of intervention, about 60 percent are now receiving
angioplasty and 40 percent
are getting surgery," Dove said. "That's a shift from what it used to be. When I first started, it was medicine or surgery."
In the past, he said, there were so few alternatives in the form of intervention procedures that
people would postpone
visiting a physician, thinking they didn't want surgery. Delaying diagnosis of their symptoms, Dove said, often resulted in an
emergency medical situation before patients sought a solution.
"Public awareness is so much greater now," he said. "It used to be that the severity of symptoms
was weighted as the severity
of disease, and that's not always a good indicator. You can have severe disease with little symptoms. People are now coming
(in) earlier, the newer procedures are available and subsequently, surgeries are fewer and the death rate has certainly gone
down."
But Dove said there's still a lot to be done in terms of prevention and earlier management of
heart disease.
"There are still a lot of people who present the first time with an acute heart attack that maybe
we could have done something
to prevent if we had seen them sooner," he said.
For instance, Prairie Heart Institute uses an electron beam computed tomography or EBCT scanner
that Dove said is particularly
useful for those with a family history of heart disease. The scan provides an idea of what the risk is. If it shows a little
bit of calcium, the doctor will address risk factors such as smoking and cholesterol level and other factors to try to
decrease the progression. If there is a lot of calcium, further studies are required to determine the course of action.
"The average age we see here (for EBCT scans) is still around 50, but we see a number of patients
in their 30s and 40s," Dove
said. "If patients had fathers who died of heart disease in their 40s, or a mother who died in her 50s, it's a pretty ominous
thing and they should definitely be checked."
Dove said genetics plays a very significant role in the risk of heart disease.
"There are people who do not follow their diet at all, but have no family history and do very well for a long time," Dove
said. "But you can have bad genetics and do the right things and certainly delay, or maybe even prevent, the development of
heart disease.
"Mitro valve disease used to be a surgery replacement but more can now be repaired," he said. "We
still see aortic stynosis
in people in their 70s and 80s, and that can only be fixed with surgery."
Dove said on the education side, Prairie Heart Institute spends a lot of time hosting educational
meetings for physicians throughout Central and Southern Illinois that focus on the latest therapies and on how to manage a
variety of diseases and problems.
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"Another part of the institute is the outreach," he said. "We go to 23 different hospitals to do
outreach medicine. We take
services there in order to allow patients to stay local and identify any problems early on. This helps get patients to come in
and be evaluated at an early stage, and hopefully helps to prevent potential heart problems."
Laurie Robertson, director of cardiac services at Southern Illinois Heart Institute at St.
Elizabeth's Hospital in Belleville,
said SIHI also specializes in the entire continuum of cardiac care.
"One of the things we take pride in is that we offer a full range of services," Robertson said.
Patients begin in cardiac diagnostics with an electrocardiogram and stress testing. If something is found there, they proceed
to the cardiac catheterization lab. Depending upon what is found there, a decision is made whether to do an intervention or to
progress to surgery.
"We do have a wide variety of cardiac intervention in the catheterization lab, and we also perform
open-heart surgery
including valves and heart bypasses," Robertson said.
Implants include pacemakers, biventricular and implantable cardioverter defibrillators.
Robertson said the cardiovascular unit provides an area for nurses to help recover the open-heart surgery patients, where they
stay before going to the telemetry unit for five days.
"After they are released, patients can then can come back to our cardiac rehabilitation outpatient
program, where they can
exercise, recover and build strength and endurance," Robertson said. "They can also take part in our support group, 'Mended
Hearts.'"
Robertson said the institute began to develop into what it is today, offering a full range of
services since 1996, when Dr.
Bill Daley came to Belleville from St. Louis to start a practice.
"Dr. Daley had four surgeons in his group, Cardio Thoracic Surgery, and we work very closely with
Cardiology Consultants - one
of the largest cardiology groups in Southern Illinois - here on site," she said. "It has definitely provided a place for
quality heart care on the Illinois side of the river. It's important to make it convenient for our patients."
Robertson said the institute does not offer transplants yet, but is starting to specialize in more
procedures in open-heart
surgery. The institute has performed approximately 150 off-pump coronary artery bypass surgeries. Robertson said it is a less
invasive procedure, allowing patients to avoid the heart/lung bypass machine, and so it is done more quickly and easily, with
less of an incision.
"People need to realize that those who come in early make a big difference in their own outcome,"
Robertson said. "They need
to realize what risk factors are, and then work at reducing the number they have. If you smoke, you're overweight, you don't
exercise and you have a poor diet, you're adding them up pretty quickly."
Southern Illinois Heart Institute provides a community outreach program in which cardiac
rehabilitation goes out to local
malls, presents information and answers questions to promote the prevention of cardiac disease. SIHI also encourages
participation in a walking program, and educates people on the risk factors associated with heart disease.
"Our programs are pretty heavily attended because people can actually ask the doctors questions,"
Robertson said. "It's
important to understand the risks that add to the problem, and the options that are now available to treat heart disease
early."
graphic designer and staff writer: Vicki Bennington
email: vbennington@ibjonline.com
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