Northern Arizona Healthcare an innovator in percutaneous coronary interventions safety

March 25, 2014

            Northern Arizona Healthcare cardiologist Jim Dwyer, M.D., was instrumental in helping develop new national safety and quality protocols for percutaneous coronary interventions, a common procedure used to open blocked arteries during a heart attack.

            Frequently, during a PCI procedure, a tiny metal mesh tube called a stent is used to help keep one or more arteries open.  A patient may undergo emergency PCI during a heart attack to limit damage to the heart muscle, or during an elective procedure to relieve angina symptoms when medications are not completely effective.

“Stenting is the absolute best way to stop a heart attack and get the blood flow restarted,” said Dwyer, who pioneered the PCI program at Verde Valley Medical Center in 2001, a time when VVMC did not offer the comprehensive range of cardiac services it offers now.

           “A stent procedure without on-site heart surgery was out-of-the-box thinking at that time,” Dwyer said. “I was doing PCIs alone for a year at VVMC, and then was joined by Dr. Bruce Peek and later by Dr. Samuel Butman.

“We caught the attention of the SCAI, who looked at our program and used it as a national model for other hospitals that wanted to offer PCI without an on-site surgical program.”

A similar PCI program was started at Flagstaff Medical Center a few years after the VVMC program. FMC later added its cardiovascular surgical program. The heart programs at VVMC and FMC have saved thousands of lives over the years since.

Dr. Dwyer recently served on a national panel composed of representatives from three leading professional organizations dedicated to the care of heart patients: the Society for Cardiovascular Angiography and Interventions, the American College of Cardiology Foundation, and the American Heart Association. The expert panel focused on protocols for health centers that perform PCI procedures without on-site cardiac surgery services.

                The new safety protocols mirror the systems VVMC has had in place since the inception of its PCI program: a well-trained support staff of nurses and radiologic technologists; a cardiologist experienced with performing PCIs, and, in the case of hospitals without cardiac surgery services, reliable emergency transport such as the Guardian Air medical helicopter stationed at VVMC.

                 In 2013, 208 PCI procedures were performed in VVMC’s Cardiac Catheterization Lab, while 205 were performed at FMC.