Bringing ‘big-city medicine a little closer to home’

By Tom Corrigan -

American Heart Month, a federally designated event marked each February, was created by President Lyndon B. Johnson on Dec. 30, 1963. The first American Heart Month took place the following February. At that time, more than half the deaths in the U.S. were caused by cardiovascular disease. The American Heart Association reports that worldwide, cardiovascular disease, including heart disease and stroke, remains the leading cause of death with more than 17.9 million deaths each year.

The heart association notes that last number is expected to rise to more than 23.6 million by 2030. In the U.S. today, 2,300 Americans die of cardiovascular disease each day, an average of one death every 38 seconds. At Southern Ohio Medical Center, thoracic and cardiac surgeon Marion Hochstetler is doing his best to reduce those numbers.

Hochstetler’s advice regarding heart health is fairly predictable. Don’t smoke, and if you do, quit as soon as possible. He also, of course, recommends a proper diet and puts a heavy emphasis on the benefits of exercise.

“We greatly underestimate the importance of exercise,” Hochstetler says, adding regular exercise can act as a sort of mini-stress test. If your regular workout routine taxes you more than usual, that could be a sign of a problem. Hochstetler says exercise obviously also provides numerous other benefits, including stress reduction, and can lead to an overall increase in positive moods. Hochstetler also talks a bit about genetics and family history of heart disease, saying they play a huge part in determining whether a person will suffer from cardiovascular disease themselves. But Hochstetler adds exercise is “our best defense against genetics.”

One other often overlooked benefit of exercise, Hochstetler says, is that it can lead to a dramatic increase in the amount of so-called good cholesterol, or LDL. Hochstetler says the importance of good LDL levels cannot be overstated, arguing low levels of LDL can be almost as dangerous to your health as smoking cigarettes.

Hochstetler says there have been, and continue to be, some important advancements in terms of treating cardiovascular disease and in the types of cardiovascular surgery. For example, the latter is becoming less and less invasive. Hochstetler talks about surgeons now being able to arthroscopically implant new heart valves with the only incisions — he actually referred to them as “needle sticks” — needed being very small ones, usually in the groin area. Instruments are used to reach the heart through blood vessels, and once the heart is accessible, a balloon destroys any damaged valves, with the new artificial valve put in place using the same pathway.

Created more a decade ago, partly by researchers in Cleveland, Hochstetler says another advancement is a device known as the Heartmate. There have now been four generations of the machine. Essentially, the device is used to temporarily replace a damaged valve, often allowing other parts of patient’s bodies to heal as they wait for permanent replacement of ailing hearts or valves.

While you might not have heard anything in the media recently, Hochstetler says research is definitely continuing into artificial hearts. He predicts the first real artificial hearts will be available in the next two decades. On yet another front, Hochstetler also talks about huge advancements in pacemakers.

In the past, the main body of pacemakers were installed above the heart with leads leading to the organ. The devices were about half the size of a cell phone and probably twice as thick. Newer pacemakers are inserted directly into the heart, are about the diameter of a pencil, and reach only a few inches long. As with newer heart valves, they can be put in place arthroscopically. They are powered by internal batteries with no leads needed, Hochstetler says. Further, they are Blue Tooth enabled, meaning they can be checked and controlled without the doctor gaining physical access to the device. Hochstetler talks about patients being able to have pacemaker checks remotely through their cell phones. The Southern Ohio Medical Center is taking steps to bring this new technology home to this portion of southern Ohio. Hochstetler says the latest generation of pacemakers were installed in local patients only in the last two or three weeks.

“We are trying hard to bring big-city medicine a little closer to home,” Hochstetler says.

By Tom Corrigan