For years, patients in Northwest Indiana had no choice but to make the 45- or more-minute trip to Chicago for advanced cardiac care.
It’s the nature of living outside the big city, where hospitals are home to extensive medical advancements and surgical procedures.
Today, however, it’s a much different story.
Hospitals in the Region offer many of the same advanced cardiac procedures that once required a trip to Chicago, and physicians say the Region is even becoming a hub for ground-breaking procedures and programs.
In Munster, for instance, cardiac electrophysiologists at Community Hospital recently became the first in Northwest Indiana to implant a tiny new pacemaker that requires no incision or skin pocket and has no lead.
Pacemakers send electrical pulses to the heart to help maintain a regular rhythm. The Medtronic Micra, designed to treat slow heartbeats, is not only leadless — it’s also the world’s smallest pacemaker at about the size of a vitamin.
For Northwest Indiana residents who will join the current 1.5 million Americans who have pacemakers, that’s good news, especially considering that with this new device, patients can undergo an MRI, a procedure traditionally not available to those with pacemakers.
Up to 50 percent of patients with standard cardiac rhythm devices can't undergo an MRI, said Dr. Wassim Ballany, an electrophysiologist at Community Hospital.
“MRI can lead to multiple hazards and risks in current traditional pacing systems including pacemaker malfunction, and device and leads heating can result in tissue damage,” he said. “The effect of MRI on the Micra leadless pacemaker system has been tested in clinical studies, which have shown that Micra pacemaker is MRI safe.”
With cardiovascular disease the No. 1 killer of women, physicians at Porter Regional Hospital are focusing on a multidisciplinary approach to women’s cardiac care.
Launched this past year, the Heart Care Center for Women combines evidence-based medical practices and new technology with other health and wellness methods, such as nutrition and yoga.
“We’re seeing a lot of positive input because people realize that cardiac problems in women are a huge epidemic that isn’t addressed,” said Dr. Maya Kommineni, a cardiologist at Porter Regional Hospital.
Another growing sector focuses on the treatment and care of cancer patients who then develop or are at risk of developing heart failure.
“We want to ensure that when they’re cured of the cancer, they aren’t dealing with a secondary problem,” Kommineni said. “But if we see warning signs, we work with them to protect their heart while they continue cancer treatment.”
The cardiology oncology program, which will launch this spring at Porter Regional, addresses cardiomyopathy and heart failure, a complication from advancements in cancer therapy that patients don’t always see coming.
“When you think about how many patients are being treated with chemotherapy and other cancer treatments, it’s been a wonderful new advancement,” Kommineni said.
Minimally invasive valve replacement
Another significant advancement being offered at Porter is aortic heart valve replacement without open-heart surgery, Kommineni said.
“Before, patients would have to go to Chicago for this procedure,” she said.
When calcium deposits build up on the aortic valve, it thickens and narrows, affecting the heart’s ability to pump blood to the rest of the body. Treatment for advanced cases is valve replacement, but some patients aren’t candidates for that because of other health conditions.
This option allows physicians to replace the heart valve through an artery in the thigh.
For patients in the south suburbs of Chicago and Northwest Indiana, health care officials at UChicago Medicine Ingalls Memorial in Harvey are building up the cardiothoracic department so a trip to the University of Chicago for care is unnecessary.
“We’re building a community-based, state-of-the-art program for cardiothoracic surgery, which will be pretty much everything short of a transplant and ventricular devices,” said Dr. Daniel Ciaburri, a cardiothoracic surgeon at Ingalls.
Before the two health care systems merged in 2016, the cardiothoracic program at Ingalls was smaller and limited in scope, Ciaburri said.
“This was a small program helping straight-forward, low-risk patients in the past,” he said. “Now it’s going to be a robust program doing all sorts of complicated surgeries.”
This includes starting a robotic thoracic surgery program, as well as using Extracorporeal Membrane Oxygenation, or ECMO, a machine used in heart surgery that pumps and oxygenates a patient’s blood outside the body that allows the heart and lungs to rest.
Ingalls officials also are working on bringing the minimally invasive valve replacement to patients within the next year, Ciaburri said.
“We’re very excited,” he said. “We think we can build a program here, and it’s needed here in the south suburbs .”
With an increase in the incidence of heart and vascular disease in the state, such advancements are important, says Connie Adams, clinical quality director with Methodist Hospitals Heart & Vascular Institute.
Also significant, she says, is a focus on wellness and prevention.
“Local residents who are supported by our care are encouraged to take an active role in their own health and wellness,” Adams said. “The focus is on patient engagement through shared decision making.”
This includes using community outreach to promote education and screening programs for local veterans, improving residents' access to fresh foods, and raising awareness about health disparities and health care advocacy.
“It’s about being a voice for people who feel like they have no voice,” Adams said.