IRMC director brings extensive surgery experience to the table

IRMC director brings extensive surgery experience to the table
By JAMES KIRLEY jim.kirley@scripps.com October 13, 2006
INDIAN RIVER COUNTY — There should be nothing novel about the first-ever open heart surgery done at Indian River Medical Center, says the doctor who will be performing it in the new $13.5 million facility that is set to open the week of Oct. 23.
INDIAN RIVER COUNTY — There should be nothing novel about the first-ever open heart surgery done at Indian River Medical Center, says the doctor who will be performing it in the new $13.5 million facility that is set to open the week of Oct. 23.
That is because Dr. Cary Stowe, IRMC's medical director for cardiovascular surgery, has done thousands of such operations. Moreover, the 54-year-old Stowe has brought several members of his surgical team with him to Vero Beach from Florida Hospital System in Orlando, where most of those surgeries were done.
"There will be a sense of cohesiveness, like a football team," said Stowe, adding he plans to begin IRMC's program with "straight-forward" cases of heart valve replacement and coronary bypass. He expects it will not take long before more complicated heart problems are getting cured locally
"If I had to guess, we will have all that up and running in six months or sooner," Stowe said.
There was a noticeable sense of excitement among hospital staff Thursday, as construction workers put the finishing touches on 28,000 square feet of new and renovated hospital space.
While repairing hearts and major arteries is the project's mission, an infusion of new talent, training and $5 million in new medical equipment is spilling over into other hospital departments.
"The improvement process really started several years ago," said Janet Longenberger, registered nurse and director of The Heart Center. Duke University Health System Inc. formed a partnership with IRMC for the center beginning in fall 2004.
"When Duke came, they did an assessment of the entire organization," Longenberger said.
Partly as a result of that process, IRMC's clinical laboratory was renovated and its blood banking capabilities expanded.
She also noted cardiac nursing experts conducted three dozen sessions to train clinical teams and 35 nurses from IRMC were sent in groups to observe operations at Sarasota Memorial Hospital's heart surgery center.
The radiology department at IRMC got the latest CAT scan machine, which uses computers to generate three-dimensional images from two-dimensional X-rays.
Thursday, Hospital Facilities Director Cliff Schroeder showed workers putting the finishing touches on a new cardiac catheterization laboratory.
It is where Dr. Joel Greenberg, IRMC's new director of interventional cardiology, and another Florida Hospital alumnus will open plaque-blocked arteries and install tiny wire scaffolds called stents to hold them open — typically working through a small incision in a patient's groin
Until now, IRMC used the same basic technique to diagnose heart disease, but could not repair blockages.
In most instances, Longenberger said, these patients will go home after less than one day at the hospital.
The Heart Center at IRMC will be the third heart surgery unit in as many Treasure Coast counties. Martin Memorial Medical Center opened its unit Aug. 1 and Lawnwood Regional Medical Center and Heart Institute opened in 1999 — the same year IRMC leaders decided to begin pursuit of their own heart center.
Critics of the proliferation of heart surgery units at smaller hospitals — they often come from institutions that have existing programs — say it takes several hundred surgeries per year to keep an operating room team proficient in the delicate and complicated procedures.
Stowe said those critics need to consider the starting point.
"Here, we are starting with a very experienced (operating room) team," he said.
It includes a heart-lung machine specialist, scrub nurse and physician's assistant who worked with Stowe in Orlando, plus his office manager and a nurse practitioner to care for patients after surgery.
"I don't think (patient) volume is as critical for a team that has prior experience and a doctor who has done thousands of these procedures," Stowe said. THE HEART CENTER AT IRMC
Officials at The Heart Center at Indian River Medical Center in Vero Beach will be ready for their first open heart surgery patient the week of Oct. 23. The following week of Oct. 30, hospital officials expect to be ready to perform their first non-surgical heart procedure using angioplasty.
HEART CENTER FACTS
• Four new operating rooms, two dedicated to heart surgery, plus one new laboratory for interventional cardiology — often called angioplasty.
• 15,000 square feet of new building, plus 13,000 square feet renovated.
• Cost of about $8.2 million for construction, plus $5 million for new equipment.
• Improvements related to heart surgery benefiting other areas of the hospital include an expanded clinical laboratory and state-of-the-art imaging equipment.