DETROIT – Come in for your heart procedure and go home the same day. That’s what some patients at Henry Ford Hospital in Detroit are doing – unlike most others, who have to stay overnight for observation.
The difference is that Henry Ford Hospital is using a technique for cardiac catheterization that allows some patients to recover at home the same day.
With cardiologists using the artery in the wrist to access the heart, there is much less risk of bleeding after the procedure. And patients recover quicker than the traditional route, through an artery in the leg.
“Going through the wrist makes for a quicker, more comfortable recovery,” says Adam Greenbaum, M.D., director of the Cardiac Catheterization Lab at Henry Ford Hospital. “Afterward, patients sit up in an armchair, keeping the wrist straight for a few hours. It’s a lot easier than lying on your back on a stretcher for six to eight hours. That’s what you have to do if your procedure was done through the leg artery. And that’s difficult for patients with back problems, or who have arthritis, or who have breathing difficulties when lying flat.”
It is estimated that approximately 10 percent of cardiac catheterizations in the U.S. are done through the wrist. Of 900 sites reporting to the National Cardiovascular Data Registry, less than 2 percent had patients discharged the same day after such a procedure.
Not everyone is a candidate to be discharged the same day as the procedure. Henry Ford has a strict set of criteria. Patients have to have someone to stay with them at home, which has to be within a certain distance to a hospital. The procedure has to have gone well, and there cannot be any problems during the hours of observation. But, if the procedure was done through the wrist and these criteria are met, it is safe for the patient to go home the day of the procedure.
Cardiac catheterization is a common medical procedure used to diagnose and treat coronary heart disease, the leading cause of death in U. S. Those with the disease have a build-up of plaque in the coronary arteries, which can cut off the blood supply to the heart. Symptoms include chest pain, or pain in the shoulders, neck, back and arms.
To unclog arteries blocked by plaque, doctors perform a procedure called angioplasty, during which a catheter with a small balloon is inserted in the wrist or leg artery and threaded to the blockage. Then the balloon is inflated, pressing the plaque against the artery wall and improving blood flow. Usually, doctors then insert a hollow tube, called a stent, into the artery to hold it open. The procedure is performed under local anesthesia.
National quality guidelines call for patients with a heart attack to undergo cardiac catheterization and balloon angioplasty within 90 minutes of arriving at the hospital. Studies have shown that performing the procedure in that timeframe greatly reduces a patient’s risk of dying. The average “door-to-balloon” time at Henry Ford Hospital is 75 minutes.
