VA Central California Health Care System
VA CCHCS Cardiac Catheterization Lab Expansion
FRESNO, Calif. – The phrase "Open your heart," is often used or heard in reference to charitable donation or fundraising for a good cause. This expression, however, takes on an entirely different meaning for the doctors and nurses at VA Central California Health Care System’s Cardiac Catheterization Laboratory, who help Veterans overcome heart blockage or clogged arteries, daily.
After a year-long process of meeting several benchmarks and making certain all necessary components and staff were in place, the cath lab is slated for an August expansion, allowing the team to offer extended services at the main VA hospital. The process included oversight by VA’s National Heart Team, as well as approval from the Veterans Health Administration in Washington, D.C.
The expansion of the cardiac cath lab will include intervention services and new techniques such as intravascular ultrasound and fractional flow reserve measuring, for enhanced timely diagnostics.
"Our goal has always been to offer the very best available staff and heart health care possible for Veterans here at VA Central California," said Dr. Ryan Berg, Director of the Cardiac Catheterization Lab at VA CCHCS.
An angiogram has been a longstanding procedure in which doctors use X-rays and liquid contrast (dye) to view the condition of blood vessels, arteries and veins, in order to search for narrowing or blockage. This provides a basic picture of what may or may not be happening inside one’s heart.
Using state-of-the-art equipment, VA CCHCS’ cath lab will employ new methodologies in cardiac science that present a more precise and accurate picture of what is happening inside the patient’s blood vessels, veins, arteries and heart. More accurate detailed imagery affords the cath lab team the ability to make diagnosis’ much faster, and start treatment plans to repair damaged or blocked arteries and blood vessels.
One of the new procedures the cath lab will use is intravascular ultrasound or IVUS. It involves a small probe that generates sound waves to produce images of the inside of the blood vessels. Fractional flow reserve, or FFR, is another recent technology in cardiac medicine that will be put into practice with the expansion. It’s a guidewire-based procedure capable of measuring blood pressure and flow through specific areas or coronary arteries. Combined, these techniques paint a clearer picture of exactly what is going on inside the heart.
For many Veterans with heart-related issues, there are added benefits to the cath lab’s ability to perform these procedures in-house. The expansion means Veterans can receive specific services or care without the additional stress of traveling to another facility. Stents, for example, can now be performed on-site at VA CCHCS by the cardiac cath team. In years past the team had to coordinate and outsource care with local hospitals or other VA hospitals that were hundreds of miles away, and patients had to travel to alternate sites for procedures such as stents and pacemakers.
The VA is among the national leaders in transradial cardiac catheterization, another recent technique in which heart-related procedures have their initial access through the radial artery in the wrist versus the femoral artery in the thigh. The VA in general does about 58 percent of cases through radial artery access as compared to about 30 percent in the private sector. The Central California VA is one of the leaders amongst the VA cath labs where radial access is used as a preferred method in over 80 percent of the patients. The cath lab treats over 300 Veterans for various heart-related illnesses each year.
Transradial catheterization is preferred over the traditional femoral insertion method due to a number of favorable advantages for Veteran patients. For instance, patients do not have to lie on their backs for hours after the procedure. Patients have also reported post-procedure recovery to be more comfortable in an upright position. This is really helpful for patients with back problems or arthritic issues. There is also less discomfort with transradial catheterization which allows for earlier mobility and faster recovery times.
The cath lab team at VA CCHCS is made up of three nurses, two radiological technologists, two doctors and a supervisory nurse manager, many of whom came to VA from surrounding hospitals and private practices.
"They are arguably the most experienced cath team in all of the Central Valley, given their combined years of experience," Berg said.
The cardiac cath team at VA CCHCS is professional and experienced, but what sets them apart is their passion for helping Veterans regain quality of life. The team is led by Berg, a graduate of Emory University in Atlanta, Ga., and Chief of Cardiology Dr. Arang Samim, who graduated from Boston University School of Medicine, in Boston, Mass.
"I chose to come to the VA to be part of the mission to provide the best possible care for Veterans," said Samim.
"I was extremely excited and humbled when my mentor, Dr. Ryan Berg, joined the VA with the vision to make VA Central California a cardiovascular center of excellence," Samim said.
Samim also said he believes the reward of working with Veterans could never be calculated.
For more information on VA CCHCS’ Cardiac Catheterization lab, please contact Erika Sutton, at Erika.Sutton@va.gov .