MARIN INDEPENDENT JOURNAL Tuesday Readers' Forum Lost time is a lost heart The Independent Journal published an Associated Press story on March 15 about treating certain types of heart attacks by promptly opening up the obstructed coronary arteries with a balloon angioplasty, often along with a stent to keep the artery open. This procedure must be performed on a heart attack patient as quickly as possible because the longer the artery is closed, the more the heart is irreversibly damaged - lost time is lost heart muscle. The American Heart Association and the American College of Cardiology have set a goal of performing this procedure within 90 minutes of a patient's arrival in the emergency room in order to increase the chances of survival and maintain heart capacity. A March 7 New York Times article discussed how difficult this goal is to achieve and how until recently the University of California at San Francisco's average response time was nearly 180 minutes, twice the specified goal. In contrast, the cardiologist and staff at Marin General Hospital embraced the concept of direct balloon angioplasty and short response times more than a decade ago and for more than 11 years has been performing this procedure around the clock, seven days a week, with times under 90 minutes. It took an average of 65 minutes in 2005 and 59 minutes in 2006 to open the artery of a heart attack patient arriving at the MGH emergency room. Although recent publications have noted how the weekend times tend to be longer for this procedure, MGH's weekend times are superb and averaged 66 minutes in 2005 and 48 minutes in 2006. These laudable statistics are in a large part due to the emergency and operating room staff's commitment. Given all the controversy over medical care in general and MGH in particular, I hope the continued excellence of our local cardiac program does not go unnoticed by the citizens of Marin. Brian L. Strunk, MD |