December 20, 2014

Surgeon writes about cardiac surgery advances at Providence Hospitals

Providence Hospitals thoracic and cardiovascular surgeon Mac Leppard M.D. recently wrote a guest column for The State about advancements the hospital has made in cardiac surgery over the past 40 years. Providence Hospitals is a ministry of the Sisters of Charity Health System.

As seen in The State:

Leppard: 40 years of world-class cardiac surgery


Guest Columnist

In the early 1970s, cardiovascular disease was the leading cause of death in the United States, and South Carolina had the greatest incidence per capita. Midlands patients had to go to Charleston or out of state for diagnosis and treatment.

Life-saving procedures were becoming available elsewhere, from cardiac catheterization to valve surgery and coronary artery bypass surgery. And so 40 years ago, Providence Hospital embarked on a journey that would bring world-class heart surgery to South Carolina.

The Sisters of Charity of St. Augustine, visionary physicians and other local leaders agreed to close the hospital’s obstetrics department — that need was being met by other local hospitals — and used that space to build a state-of-the-art, comprehensive department of cardiovascular services.

It opened in February 1974, and the first open-heart surgery was performed there by Dr. John P. Sutton on Sept. 11, 1974. Providence had begun its conversion into the state’s leading heart facility.

But that didn’t happen overnight.

It hadn’t happened yet in 1977, when my father needed heart surgery. He lived in Chesterfield, and his physicians, wanting him to have the care of a hospital with a proven track record, sent him to Houston. Today, he would be sent to Providence.

What makes Providence the best? Longevity and experience, and a determination to stay on the leading edge of innovation.

I started practicing at Providence 30 years ago, and today I am one of four heart surgeons at the hospital. Two of the doctors I practice with are the sons of surgeons who were here when I arrived.

But as much as we’d like to claim all the credit, the excellence of our program is not just about the surgeons. Our team includes cardiologists, cardiac anesthesiologists, emergency physicians, pulmonologists, cardiac nurses, operating room staff, cardiovascular physician assistants, certified RN anesthetists, perfusionists, dietitians, chaplains, pharmacists, physical, occupational and respiratory therapists and social workers.

It takes an entire team to treat the whole person, and that’s what we do at Providence. For example, those in the operating room usually know exactly what I need before I say a word.

That makes the difference. With anything as complex as open-heart surgery, the more you do it, the better you become. At Providence, we’ve done it more than 35,000 times, and we’re constantly pushing to improve.

Today, we perform most of our bypass procedures off the pump. That means we operate with the heart still beating. In our experience, there are a number of advantages to beating-heart surgery. The most obvious is that we don’t have to stop your heart. The patient also can be removed from the respirator more quickly. And the rate of stroke and other complications is reduced.

This method is more difficult, requiring higher and more specialized skill and experience. But it’s better for the patient, so we do it. And we do it far more than other hospitals. Nationally, 19 percent of bypasses are done off the pump; our rate is 93 percent.

Several weeks ago, we received word that once again, Providence was being recognized by the Society of Thoracic Surgeons with its top rating, three stars. This is the gold standard in heart surgery. You can’t fudge a test like this. The society comes in and audits your results, judging you not only on whether patients survive but on their quality of life afterward, and whether you employ best surgical and other practices.

It would be an honor to receive this distinction once. Providence has done so all 16 times since the society created the rating system in 2006 (the ratings are issued every six months). It means we are consistently among the top 10 percent to 15 percent in the nation.

This is what we’re celebrating at Providence: a program that, after 40 years of building, is an unparalleled, life-saving, life-enhancing asset to South Carolina. Providence Hospital was and is a leader in bringing world-class cardiac surgery to our state.




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