Board of Health meeting

Dr. Christopher Mallavarapu of the Olean General Hospital Cardiac Catheterization Lab speaks Wednesday at the Cattaraugus County Board of Health.

ALLEGANY —  The Interventional Cardiac Catheterization Laboratory at Olean General Hospital opened Oct. 1, 2013.

It is the only hospital in southwestern New York that can find and fix serious heart issues, Dr. Christopher Mallavarapu told members of the Cattaraugus County Board of Health on Wednesday.

Over the past 11 months, the cardiac lab, a partnership between Olean General Hospital and gates Vascular Institute in Buffalo, has done 554 procedures, including 1,211 interventions and 51 STEMIs (ST Segment Elevation Myocardial infarction), caused by prolonged blockage of blood supply in the heart.

Dr. Mallavarapu said, up until a few years ago, emergency medical services from fire departments around the county were trained to get heart attack victims to cardiac care as soon as possible. That usually meant a medical helicopter trip to hospitals in Buffalo, Rochester or Erie, Pa.

He spoke about the importance of the “golden hour” in treating heart attack victims. “Now, we can fix things (here) right away and save a significant amount of (heart) muscle.”

The average American male will have a heart attack by age 66; for women the is age 70, Dr. Mallavarapu said. Looking around the table at the Board of Health meeting at the St. Bonaventure Clubhouse, he said, “Everybody probably has some degree of (coronary) blockage.” Coupled with high blood pressure, diabetes, high cholesterol and other risk factors, an artery narrowed by plaque could burst, causing a major blockage leading to a heart attack.

“EMS plays a critical role here,” Dr. Mallavarapu said. Some can transmit EKGs of a patient from an ambulance en route to the hospital. In this case, the cardiac team is ready when the patient arrives at the door of the heart lab.

“The goal is to try to get (into the heart) within 60 minutes” of the attack, Dr. Mallavarapu said. Half of the patients arrive at the heart lab in ambulances, while about half are walk-ins who suspect they are having a heart attack.

Most heart attack patients who have a stent placed in an artery to keep it open, or a blockage removed, are often discharged from the hospital in three days with follow-up care, Dr. Mallavarapu said. For patients who have to wait up to two hours, the statistics are not nearly as positive, he added.

“Where you live should not determine if you live,” Dr. Mallavarapu said.

Nearly one-third of the Olean heart lab’s patients come from neighboring Pennsylvania counties, while 65 percent are from Cattaraugus County, he said.

Dr. Gilbert Witte, the county Health Department’s medical director, said Olean General Hospital’s cardiac catheterization lab “has really made a difference” even though “it took a long time to get here.”

Dr. Mallavarapu said with the Olean heart lab, “It makes no sense” not to drive a patient from the western part of the county to Olean General Hospital — even though WCA Hospital in Jamestown may be closer with the use of a medical helicopter. That is because if driven to Olean, the patient could get the needed care, while if he is taken to the Jamestown hospital it’s likely he would have to be airlifted again to UPMC Hamot Medical Center in Erie, Pa., which all takes time.

The EMS crew has a shorter ambulance run, but it is not always in the best interest of the heart attack patient, Dr. Mallavarapu said.

One Board of Health member, Dr. Zahid Chohan, said more doctors should be sending their patients for elective surgery to clear blockages before they trigger a massive heart attack.

“They are spending more time in an ambulance rather than bringing them directly to Olean General Hospital.” EMS crews need to be educated that “this (heart) service is available at Olean General.”

Dr. Witte added, “They are still taking them to other places that can’t help them.”

Dr. Watkins, who is a member of the Cattaraugus County Emergency Medical Services Council, said he would raise the issue of getting heart attack patients quicker care by rushing them to Olean General Hospital rather than waiting for one or more helicopter transports to a hospital with a cardiac care facility that can do interventions.

 

Contact reporter Rick Miller at rmiller@oleantimesherald.com and follow him on Twitter, @RMillerOTH)

 

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