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Neighbors Growing Together | Jul 19, 2018

Mercy performs its first open heart surgery

Hospital got state approval for program one year ago
Nov 14, 2017

By Michaela Ramm, The Gazette


CEDAR RAPIDS — About a year after receiving state approval for a cardiovascular surgical program, Mercy Medical Center successfully performed its first open heart surgery this month.

The surgical team — led by Dr. C.C. Lee, the hospital’s medical director of cardiac, thoracic and vascular surgery services — performed a triple coronary artery bypass grafting on Nov. 1.

The surgery was meant to improve blood flow to the heart for the patient, John Fritz, a 66-year-old Marion resident.

“He had blockages in his coronary arteries,” Lee said. “If he didn’t have them (the grafts), he was at risk of having a heart attack.”

As of last week, Mercy’s surgical team since has performed three open heart surgeries at the hospital.

In November of this past year, Mercy officials obtained a certificate of need from the State Health Facilities Council, part of the Iowa Department of Public Health, to start the surgical program. Hospitals and other medical providers are required to go through the review process for new services and medical equipment costing more than $1.5 million.

Lee said its new program allows for the hospital to repair its fragmented continuum of care.

Before the surgical program began, a patient coming to Mercy for heart issues could be seen by cardiologists and have heart catheterization procedures, but then would have to be transferred to other hospitals for the open heart surgeries, such as at UnityPoint-St. Luke’s Hospital in Cedar Rapids.

Officials say the hospital had to transfer 150 patients a year on average to other facilities.

“It’s going to be good for the consumer, they can now have another facility they can choose if they want to have their heart surgeries here,” Lee said.

However, there was pushback during the certificate-of-need process from St. Luke’s and other hospitals that had argued Eastern Iowa’s needs already were being met.

In its opposition letter when Mercy first went before the State Health Facilities Council in June 2016, St. Luke’s pointed to a section of Iowa code that requires a new cardiovascular surgical program to perform at least 200 surgeries a year. Therefore, those 150 cases are not enough to establish a program, the hospital’s officials argued.

According to Iowa Hospital Association data, St. Luke’s performed 328 open heart surgeries in 2015.

The association maintains the level of scrutiny from the Health Facilities Council is necessary to ensure the best care for its state’s patients, spokesman Scott McIntyre said.

While hospitals and providers may see a market for the service that would improve the hospital financially, the goal of the certificate-of-need process is to fill community needs.

Lee, who was brought on in June to build up the program, recruited staff from within the hospital, and the team conducted training and mock surgeries over the following months. Mercy intensive care unit nurses and operating room staff also received training at Mercy Medical Center in Des Moines. The two facilities are not affiliated with each other.

The team was ready by the time Fritz was admitted to the hospital a week before the surgery for his symptoms. He had been experiencing a sensation on one side of his body — almost as if it was falling asleep, he said — had high blood pressure and some visual disturbances.

Months earlier, while doing yard work in Marion, he felt his chest burning. Fritz chalked it all up to his age, until his daughter Jennifer Hawkins, practice administrator at Oncology Associates at Hall-Perrine Cancer Center, urged him to get a check up.

Fritz said that probably saved his life.

With “men, if you don’t have any big symptoms, you don’t think there’s anything wrong until you mention it to someone,” Fritz said. “I had been doing work the week before I probably shouldn’t be doing — cutting the tree line, cleaning gutters.”

Fritz was discharged on Nov. 5 and now is at home, recovering.

Although there are a lot of growing pains with establishing this new program, Lee said after this first successful surgery, Mercy’s cardiovascular surgical program shows promise going forward.

“My vision is to create a program that’s more than just a community program,” Lee said. “I want to create a tertiary-type program where we can compete with the University (of Iowa), Mayo Clinic, Des Moines, so that patients don’t have to travel to other facilities to have surgeries when it can be done right here in Cedar Rapids.”

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