HEARTS CAN BE MENDED LOCALLY

Patients who require open-heart surgery, the most common surgery performed in the United States today, don't have to travel to metropolitan areas to find modern facilities and a qualified staff. In Cape Girardeau, two hospitals are projected to perform a total of 500 open-heart surgeries this year.

Open-heart surgeries include more than just bypass operations with which most people are most familiar. Open-heart surgery relates to open-chest surgery when the heart is being operated on. The most commonly performed open-heart surgeries are coronary artery bypass grafting, valve repair or valve replacement or a combination of repair and replacement, aneurysm repair and the repair of an abnormal hole or leak in the heart.

Southeast Missouri Hospital, which is projected to perform 300 procedures this year in the Regional Heart Center, is celebrating its 10th anniversary of open-heart surgery. Heading the cardiovascular surgery team at Southeast are Drs. Robert W. Ruess, J. Darryl Ramsey and Steven C. Bailey.

The Regional Heart Center team has completed more than 2,325 open-heart surgeries. The patients have ranged in age from 27 to 91.

Southeast Hospital Administrator James W. Wente said a 12-bed --Cardiothoracic Intensive-Care Unit will open in December. It is especially designed for open-heart surgery patients in the immediate post-operative phase of care.

"We are extremely excited and proud to be able to open these new units," Wente said.

Maggie Schuch, cardiothoracic nurse manager who was recently named Critical Care Nurse of the Year by Southeast Missouri AACN Chapter, explained how the new unit will work:

"The patients come out of the operating room directly to ICU, where we recover them. As soon as patients are awake, we wean them off the breathing machine. In our unit we can monitor their heart function closely and the nurses have special training for post-op open-heart recuperation of patients."

According to Wente, a team effort is required for successful complete care of heart patients.

"We have a comprehensive special protocol when the heart patient comes in," he explained. "While the facilities are nice, it doesn't mean anything unless there is a competent staff and teamwork."

O.D. Niswonger, who was hospital administrator in 1984 when the hospital began its heart surgery program, says starting the regional heart center probably was the most gratifying experience he had as administrator.

"I never saw such cooperation between departments to get the job done," he said.

Mary Doris Zoellner of Charleston had open-heart surgery at Southeast in 1985. She chose the hospital because it was near her home.

"I am so grateful to every member of the heart team because they have given me nine years of above-average quality of life," she said. "I am 74 years old and I can walk three miles a day. I thought the care at Southeast was the best there could have been!"

At St. Francis Medical Center, which began its open-heart surgery program in 1991, 200 surgeries are projected to be performed this year. The heart team is composed of cardiothoracic surgeons Drs. Louis Ostrow and Marc Schechter and peripheral vascular surgeon Bridget Ostrow. The program is affiliated with the Thoracic and Cardiovascular Surgery Association of Memphis, Tenn., of which Dr. Glenn V. Crosby, a highly respected cardiothoracic surgeon, is a member. The Memphis group provides backup if needed.

Dale Rauh, director of the Heart Institute at St. Francis, says there is a definite need for two open-heart programs in this community. The geographical area served is composed of 17 counties in Missouri and five counties in Southern Illinois.

"In 1990, prior to opening our program, we did a study," he said. "The potential need in the 22-county area is for 800 open-heart surgeries per year. With 500 projected to be performed in Cape Girardeau this year, we still are not serving everyone."

Jess D. Hopple of Cape Girardeau chose St. Francis for his open-heart procedure in April because he lives 1/4 mile from the facility.

Hopple, who has traveled throughout the world and lived in St. Louis and San Jose, Calif., before he moved to Cape Girardeau four years ago, feels the heart facilities at either hospital here are better than in metropolitan areas because there is more personal involvement at the smaller facilities.

Hopple, who is president of Cape Girardeau St. Francis Mended Heart Chapter 261, was impressed with his care at St. Francis.

"I could not have asked for better care," he said. "I am very impressed with the rehab program at St. Francis. They walked me through it and back to health"

"I feel there are too many people in this area who are not aware of what each hospital has to offer," Hopple said.

The addition of open-heart surgery has been a major step forward for the area served by Cape Girardeau hospitals.

In 1984, when the procedure was first offered, Southeast Missouri had the highest death rate in the state due to cardiovascular-related diseases, and the area also had the state's highest population of elderly Missourians.

Southeast Missouri still has a slightly higher elderly population and therefore a higher incidence of heart disease than the rest of the state.

Cardiologist C.R. Talbert Jr. said the average patient having surgery here is several years older than the average patient in metropolitan areas. Many are unwilling or unable to travel to cities for the procedure. The added expense and stress for family members pose a problem.

"There is no question that having the service here over the last 10 years has saved lives," Talbert said.