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Healing hearts in the Valley

Hospitals mark anniversaries of 2 major surgeries

Staff photo / Allie Vugrincic Alexis Stipanovich, RN, on the open heart team at Trumbull Regional Medical Center, helps with a mock open-heart surgery preparation Thursday. In the background is Kris Shaw, a Certified Scrub Technician.

Sixty years ago this month, life in the Mahoning Valley changed forever with the closure of a hole in a heart.

The June 11, 1962, surgery at Mercy Health Youngstown performed by Dr. Edmund Massullo was the first open-heart surgery done in the Mahoning Valley. It lasted four hours.

The patient, Cora Rushton, was just 2 years old at the time, according to various reports celebrating the 50th anniversary of the surgery in 2012.

Twenty years ago, in November 2002, another hospital hit a milestone in cardiac care as the first open-heart surgery was performed at Trumbull Regional Medical Center in Warren on then 55-year-old Mark Fulmer of Lordstown, who was having a heart attack.

“You have to have a beginning,” said Dr. Lucas Henn, medical director of cardiothoracic surgery at Mercy Health-Youngstown, comparing open-heart surgery to the evolution of cars: You can’t have a car that drives 200 miles per hour without first having a car that drives 50 miles per hour. Likewise, you can’t have complex, life-saving surgeries without that first, four-hour endeavor.

BEGINNING

“Every 10 years there’s kind of a reminder of how far we’ve come, but also where our beginnings were,” Henn said.

He said 60 years ago, Dr. Massullo was an “innovator and a pioneer” who brought heart surgery to the Valley when heart-lung bypass machines, which takes over the functions of the heart and lungs during surgery, only had been in existence for about 10 years.

Henn, who has been at Mercy Health Youngstown for nearly 10 years, said he benefits from the work Massullo did and “stands on his shoulders.”

Henn said the open-heart surgery of Massullo’s time was different than today’s procedures, in that technology and sterilization and operating techniques still were developing. Closing a hole in the heart now wouldn’t necessitate opening the heart, Henn said. It could be done percutaneously, or through the skin.

TEAMWORK

Evolving techniques and technology have led to innovations in open-heart surgery like the ability to do surgery on heart valves or the aorta, the main artery that carries blood away from the heart. In some cases, doctors also can perform off-pump or “beating heart” surgery, a bypass performed while the patient’s heart continues to beat, explained Dr. Randy Metcalf, cardiothoracic surgeon at Trumbull Regional Medical Center.

Still, opening up a heart is no small task — it takes a skilled team, from diagnostics to recovery.

“I don’t think people realize how many individuals are involved in just any one patient’s operation,” Metcalf said.

He said patients are first interviewed, examined and tested before the operation begins. The operation itself involves scrub technicians, operating room nurses, physicians’ assistants, an anesthetist, a perfusionist and a surgeon.

Another set of experts take over care in recovery. At Trumbull, patients usually are taken off ventilators the same day as the surgery, sitting up in a chair the next day, and walking on the third, Metcalf said.

“Having a heart program here in the area is really paramount, and it’s really beneficial to this community,” Metcalf said.

Part of the benefit is that a patient’s family members can go to their own homes at night while knowing their loved ones are getting the same level of care they would elsewhere.

Plus, having heart programs available nearby means faster care during an emergency.

EMERGENCY

Fulmer, now 75, the somewhat accidental first open-heart patient at Trumbull Regional Medical Center, said it was a Friday night in early November 2002 when he started feeling clammy and sweaty and had pains in his arm. When he arrived at the emergency room, he found out he had a blockage in an artery and was having a heart attack.

Unbeknownst to Fulmer, staff at Trumbull Regional was in training to perform open-heart surgeries.

“It just happened to come together. I was fortunate that the nurses were there training our nurses and our staff,” Fulmer said.

Fulmer at the time worked in the biomedical department at Trumbull Regional, maintaining the equipment that keeps people alive during surgery.

Fulmer later had two more heart attacks, in December 2002 and in 2012. During the 2012 event, Fulmer’s cardiologist at Trumbull, Dr. Fadi Naddour, put a stent in one of his arteries.

A stent is a mesh tube used to hold arteries open. It is a nonsurgical coronary intervention.

HEART HEALTH

Naddour was not Fulmer’s first cardiologist at Trumbull, but he has been at the hospital since the inception of its heart surgery program 20 years ago. He said the hospital started its cardiac cath lab for diagnostic catheterization in 2000, before the hospital’s first heart surgery.

Today, the heart program can run a number of tests to determine patients’ risks for coronary disease, including a coronary CTA, which uses X-rays to look at coronary arteries, and a cardiac CT calcium score, which determines the amount of hard plaque in the heart, among others.

Naddour stresses the importance of people over the age of 40 knowing their cardiovascular risk score — their risk of heart disease — which can be calculated online. Those with high cardiovascular scores need to treat cholesterol and blood pressure aggressively, and undergo medical testing if they notice any symptoms, he said.

“It’s a lot better to find out about coronary disease during a screening process than to have that treated after they had a heart attack or damage. It makes a big difference,” Naddour said.

Naddour also advises anyone who is having a cardiac event to call an ambulance right away — waiting can cost you your life. Naddour said he has seen instances where people have died because they chose to have a family member drive them to the hospital and they haven’t gotten there fast enough.

Emergency medical personnel, however, can start treatment right away and send doctors at the hospital the information they need to prepare and treat a patient as quickly as possible upon arrival.

“Death from heart attack can be prevented more than any other death in medicine with simple medical procedures and with minimal discomfort for the patients, as long as patients know how to seek attention quickly and go to the right place,” Naddour said.

Naddour said the key to heart health is living a healthy lifestyle. He said his patient, Fulmer, is a good example of that.

Fulmer, who is physically active, began eating vegan about seven years ago when his wife developed stomach issues. While his heart problems slowed him down, Fulmer has not had any trouble with the organ in the last decade.

“I have to watch sometimes. My breathing gets a little bit tough,” Fulmer said. “I’ve learned some things over the years … you know, the doctors always say– and it’s true — exercise and diet.”

TODAY

Naddour said Trumbull Regional’s heart program progressed very quickly in its first years, and the hospital now does a large number of open-heart surgeries and complex coronary interventions per year.

Mercy Health Youngstown performs around 400 heart interventions and surgeries per year — and that number is increasing, Dr. Henn said.

Both hospitals offer a wide array of cardiac care, offering Valley residents almost any coronary service they may need, except heart transplants.

“I think the take home for this is it’s really amazing that heart surgery has been done in this town for 60 years. That’s a tremendously long time, and if you think about the advances that have been made in other fields in that 60 years — we’re trying to be right on par with those other advances,” Henn said. “We’re happy to be on the forefront and following the lead of Dr. Edmund Massullo.”

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