Interventional Cardiology Now at FCHC Heart and Vascular Center
When FCHC first opened its Heart & Vascular Center in 2007, the Heart Catheterization Lab was initially used for diagnostic cardiology services. Now, with the addition of board-certified interventional cardiologist Charles Gbur, Jr., MD, the lab’s capabilities can now include interventional cardiology so patients could be diagnosed and treated at the same time for heart issues.
Dr. Gbur brings over 35 years of medical experience to FCHC, with the last 20 years spent as an interventional cardiologist at McLaren St. Luke’s Hospital in Maumee. He received his medical degree from The Ohio State University College of Medicine in 1987. He completed his internship and internal medicine residency at The Ohio State University Hospital. He completed his cardiology fellowship at the Medical College of Virginia in Richmon. He also did graduate work in molecular physiology at Virginia Commonwealth University in the Department of Physiology and Biophysics. There, he did Advanced studies in vascular physiology and molecular cloning techniques. Dr. Gbur retired from the US Navy (res) after 25 years of service as a Commander in the Medical Corps. He was a graduate of the United States Naval War College (Distance Learning Program) as well as the Joint Forces Staff College.
What is Interventional Cardiology?
Interventional cardiology is a minimally invasive, non-surgical treatment that uses a small, flexible tube called a catheter to allow narrowed or blocked arteries to be treated with balloons, stents, and other devices. Patients benefit from the fact it is much less invasive than traditional open-heart surgeries with faster recovery times.
There are a variety of procedures that Dr. Gbur currently performs in the FCHC Heart and Vascular Center. These procedures include pacemakers, implantable cardioverter defibrillators (ICD), implantable cardiac monitoring (loop recorders), holter and event monitors, cardioversions, transesophageal echocardiograms as well as peripheral vascular procedures such as balloons and stents. Our cath lab will begin to treat coronary cases later this summer, and we will begin treating all cardiac emergencies early next spring.
Technology Has Advanced
“If you go back 20 years, the typical coronary intervention was to use balloon angioplasty to open blocked arteries,” says Dr. Gbur. “We would insert a small balloon through catheter in the artery in the groin leading to the heart to stretch the blockage. The problem was that it could fail. As a result, the procedure required a surgeon to be on standby when angioplasty was used in case it failed. When that happened, the patient would need immediate open-heart surgery to correct the blockage.”
Dr. Gbur says today, heart stents are used almost exclusively compared to balloon angioplasty. Heart stents are tiny, lattice-shaped metal tubes that are inserted through the artery in the groin or wrist and serve as scaffolding to keep the artery open.
“With the use of stents and the advancement in the techniques we use, a surgical backup is no longer needed,” says Dr. Gbur. “Patient outcomes have improved significantly, and the success rate of the stent is typically 95 to 99% in appropriately selected patients.” He adds that recovery from the use of a stent is also better now than it was in the past. “I’ve had patients return to work within 24 hours of having an interventional procedure.”
Time is of the Essence
Patients that have a heart attack need to be seen and cared for quickly. “We have the ability to
diagnose and stabilize our patients through our Emergency Department and CCU,” says Lisa Cheney, BSN, RN, Director of Cardiovascular Services.
“Once we determine that a patient is having a heart attack, we have a 90-minute window of opportunity to treat a patient’s heart attack with a stent to get the best possible outcome for the patient,” says Dr. Gbur. “Our goal is to have a door to balloon time of 40 to 45 minutes to diagnose and treat with a stent. Transportation time that must be accounted for, so having the ability to perform these procedures locally will improve patient outcomes. It’s critical to get the patient treated quickly. We have the capability to do all of that here at FCHC without delaying care and having the patient transferred to another hospital for the intervention.”
Advice from the Cardiologist
Dr. Gbur is well-known by patients in the area who he treated before coming to FCHC. In fact, many of his Toledo area patients have continued with him at FCHC. “I tell all my patients that I may be able to fix their blockage with a stent, but it will not cure their heart disease,” says Dr. Gbur. “We have to determine what the underlying problem is that caused the blockage in the first place and then address it. That may mean the patient has to give up smoking, lose weight, improve their diet, and begin an exercise program. But it’s important for patients to know there are solutions for heart disease.”
The Vascular Side of Things
“In addition to the interventional cardiology procedures performed in the Heart & Vascular Center, we also do diagnostic and interventional vascular procedures as well,” says Cheney. The vascular cases that we do perform in the cath lab are: carotid angiography and stents, pulmonary angiogram, arterial and venous thrombectomy, inferior vena caval filter placement, fistulograms, and fistula and draft de-clotting for hemodialysis patients. We are also part of the Pulmonary Embolism Response Team (PERT) Consortium and have a team in place to treat pulmonary embolisms and deep vein thrombosis as well.
Teamwork & Experience
“We have a strong team of doctors and nurses at FCHC, who have been caring for emergency situations for many years,” says Cheney. “We recently added Laura Rodriguez, RN, as our Heart & Vascular Educator to assist patients. She is a Wauseon native and has worked at FCHC in the past. In fact, she assisted in the opening of the original catheterization lab in 2008.”
After working at FCHC, Rodriguez moved to the former McLaren St. Luke’s hospital in Maumee as a nurse in their Interventional Services (IVS) recovery area and cardiac catheterization lab. She was promoted to Nurse Manager of the cardiac catheterization lab, interventional radiology (IR), electrocardiography, echocardiography, stress lab, and IVS/IR recovery. “I’m excited to come back to FCHC where I can share my knowledge and experience with the team while serving my own community,” says Rodriguez. “I’m looking forward to the growth of the cardiovascular program at FCHC.”
Improving Patient Outcomes
“With the addition of an interventional cardiologist on staff, we can improve patient outcomes by decreasing the time for treatment of many cardiovascular emergencies,” says Cheney.
“The ability to handle high acuity patients with heart issues has changed the landscape of capabilities at FCHC,” adds Dr. Gbur. “Patients benefit since they can stay in town for both diagnosis and treatment. This will also benefit patients presenting with non-cardiac problems who also have heart disease. In the past, these patients needed to be transferred to another facility for care. Family members benefit as well since they can stay close to their loved ones and provide emotional support.”