SARATOGA SPRINGS – Because minutes matter, an important service recently instituted at Saratoga Hospital that offers emergency cardiac interventions for heart attack patients has potentially life-saving ramifications.
“Saratoga Hospital is now at the tip of the spear of a public health effort to bring the most effective treatment ever invented to the world’s deadliest disease,” explained Dr. Patrick McNulty, director of Interventional Cardiology at the hospital.
The minimally invasive, catheter-based procedures is available 24-hours-a-day, seven days a week. What that means is patients requiring treatment for heart conditions won’t lose precious time being transported beyond Saratoga County.
“The best chance of survival is getting the blocked artery open as quickly as possible, so it’s a matter of how many minutes you have,” McNulty said. “The faster you can get to a hospital that has this effective treatment and get it done, the better chance you’re going to have of surviving - and surviving in a way that gives you a better quality of life that allows you to be functional.
“When I was starting my training, patients with heart attacks were admitted to the hospital just like people with pneumonia or broken legs,” said McNulty, who has conducted 30 years of cardiology training. “They’d be in the hospital 10 days or so, their heart would undergo enormous amounts of damage and they would have all sorts of complications. Most of the training in being a cardiologist back then was a matter of training to treat all of the electrical and mechanical complications after people had big heart attacks. This was 20 years after we landed on the moon, so this was not the dark ages - but still the treatment of heart attacks was pretty primitive.”
Clinical research trials were conducted during the 1990s and it was determined the fix involved getting people with heart attacks caused by blocked arteries into an operating room and conducting a minimum evasive operation to open the blocked artery with a balloon. Moving forward, the research indicated patients would be best served having an emergency operation. The issue then became how to make that procedure more readily available to people having heart attacks.
“It requires sophisticated technicians and physicians and nurses working as a team in a complicated medical facility at a large hospital,” McNulty said.
A little over a decade ago, when Angelo Calbone became Saratoga Hospital president and CEO, he says the question was: How do we move Saratoga Hospital into a position of what the community needs? “The vision of Saratoga Hospital for many years was as the hospital for Saratoga Springs. We wanted our scope and vision to be much bigger than that. We thought it was part of our responsibility as the only hospital in the county.”
A lot can change in a decade. Technological advances, such as robotic surgery, were brought in. Emergency rooms and the Intensive Care Unit were expanded and improved. Older operating rooms were replaced with new ones, built to accommodate members of the staff, surgeons, robots, and supplies required in present-day procedures. The hospital grew its regional footprint by adding off-site services in places like Wilton, Malta, Galway, Schuylerville, and others. It also developed a “medical group,” that incorporates professionals who had previously operated their practices independently.
“We have over 100 physicians now that work inside with us. We see them as our partner and they see us as their home organization,” Calbone said. “We had to get a little bigger and reach further out into the county. Ten-plus years ago, we said we’d like no one in the county to be further than 10 minutes from one of our services. By the time we’re done, over the next few years, we will fulfill that. We still have our eyes on two or three other places in the county where we can expand some programs and physician services.”
The hospital built upon its growing momentum and invested in a 50-50 joint venture with Albany Medical Center at Exit 12 in Malta, which Calbone said has been very successful and is a direct connection to being able to bring McNulty to the community and setting up its 24/7 emergency interventional cardiology service.
“Ten years ago, New York State did not have any hospitals offering coronary angioplasty for heart attacks except for hospitals that also did heart transplants and heart valve replacement surgery,” McNulty said. “Now, Saratoga Hospital offers a procedure so complicated and technically demanding that no hospital in the world offered it until 20 years ago, and only very large tertiary academic medical centers offered it 10 years ago.”
Hospital facilities were renovated and the Saratoga staff trained in March in preparation of the service. Since that time, the hospital has served 20 patients.
“Those 20 cases were 100 percent successful,” McNulty said. “The mean time it’s taken to get people in here, assemble the team, stabilize the patient, get them to the operating room and fix the artery in the last four months is 59.6 minutes, (less than the) 90 minutes that the government says you should be aiming for. And so now, after a year or two of preparing and four months of early experience, in the way that it provides this one critical service Saratoga Hospital is hitting the same type of quality benchmarks as some of the largest and most sophisticated hospitals in the country.”