Heart and Vascular E-News
A quarterly newsletter from Research Medical Center

May 2009

phyllis2 From the Director....

Even though February (Heart Month) has come and gone, we are continuing our emphasis on heart disease with Go Red for Women and the Heart Walk on May 30. We are hopeful for great weather and many walkers. Thanks to all who are supporting this initiative.

Much has happened in the treatment of heart disease. One of the markers we watch is the door-to-balloon time for the heart attack patient or the time it takes from the minute the patient arrives at the hospital door to the time we have the blocked artery open in the cath lab. In the past few years, most hospitals have struggled to get to the 90 minute goal but through hard work and process changes, we have been driving that number down for a much better outcome for the patient. During the month of March, the median door-to-balloon time at Research Medical Center was 42 minutes. This can only be achieved by a concentrated effort among ambulance services, our emergency room staff and the cath lab. We applaud them for their work.

Research Medical Center has been recognized for the second time within the past eight months for its achievement in implementing the American Heart Association/American Stroke Association Get With The GuidelinesSM (GWTG) for coronary artery disease, stroke and heart failure. Research Medical Center has now achieved the GWTG Gold Performance Achievement Award in coronary artery disease, the Silver Performance Achievement Award for stroke and Silver Performance Achievement Award for heart failure.

Phyllis Vos, RN, MSN, CCRN
Director, Cardiovascular Services
Research Medical Center

Calendar of Events

May 30
Heart Walk
@ Theis Park
8 a.m.

Aug. 18

20th Annual Research
Golf Classic
@ Loch Lloyd C.C.
9 a.m.

Nov. 7
8th Research Royal Rebound
@ Sprint Center's
College Basketball Experience
7 p.m.

Nov. 13
26th Annual Bixby
Cardiology Symposium
@ Sheraton Overland Park
8 a.m.

Physician Spotlight
Eric Hockstad, MD, F.A.C.C.
Interventional Cardiologist

hockstad09 Eric Hockstad, MD, F.A.C.C., joined Kansas City Cardiology Associates in 1996 and is the director of Interventional Cardiology at Research Medical Center. He practices general cardiology and has a primary interest in interventional cardiology. He received his undergraduate and medical degrees at the University of Michigan, and completed internal medicine and general cardiology training at the University of Minnesota. After completing his cardiology fellowship, he was selected for an Interventional Cardiology Fellowship at the University of Minnesota. During his education he received many honors and awards, including the National Research Service Award and the Joseph Collins Foundation Scholar Award. In 2000 he co-founded the Kansas City Heart Foundation, dedicated to performing world class cardiovascular research.

He has served as principal investigator for several Kansas City Heart Foundation projects, investigating new medicines that may remove plaque, new stent designs, and medicine to prevent kidney injury during acute heart failure. He was named a Kansas City Top Doctor of 2003 by Ingram's magazine, and is perennially named a "Super Doctor" in KC Magazine. His clinical interests include advanced coronary and peripheral interventions, risk factor therapy and performance improvement/quality assessments.
Dr. Hockstad specializes in coronary, peripheral, and carotid intervention, and percutaneous treatment of patent foramen ovale and atrial septal defects.

In this month's issue, Dr. Hockstad highlights the treatment of patent foramen ovale and atrial septal defects.

Patent Foramen Ovale and Atrial Septal Defects

Patent foramen ovale (PFO) and atrial septal defects (ASD) are found in the wall separating the right atrium from the left atrium. These defects can allow blood or blood clots to cross from the right side of the heart (right atrium), into the left atrium. PFOs have a flap that covers a small hole, while ASDs are clear openings between the two chambers. PFOs are common, found in up to 20 percent of patients, while ASDs are rare. Blood clots rarely cross from the right heart into the left heart via a PFO, which can then sometimes lead to the brain and cause a stroke.

There is also limited evidence that PFOs are also associated with migraines, although there is not yet enough evidence to clearly link the two. ASDs can allow large volumes of blood to shift from the left heart into the right heart. This can lead to high pressures in the arteries of the lungs, and to right heart failure. In the past, both abnormalities were treated with open heart surgery. Now both defects can be closed with a device that is placed through a catheter. The procedure only takes an hour or so and patients can leave the hospital the following day with minimal restrictions.

For more information about the treatment of patent foramen ovale and atrial septal defects, contact the Cardiovascular department at (816) 276-4277.

RMC Opens Center for Ancillary Prep
and Procedure Services

Research Medical Center has recently opened The Center for Ancillary Prep and Procedure Services (CAPPS). The new unit, previously known as the Surgery Prep Area, is located between Radiation Oncology and Gamma Knife on A-level. The patients being processed through this unit include: Interventional Radiology outpatients, cardiovascular patients and Outpatient IV infusion/clinic patients. These patients were previously processed through Outpatient West.

  Heart Clinic Improves Quality of Life,
Patient Outcomes

The Heart Clinic, located in the multi-specialty clinic at Research Medical Center, provides a model program for heart failure and anticoagulation management that improves quality of life and patient outcomes. The clinic is staffed by a nurse practitioner and nurse clinicians who are directed by experienced cardiologists. Heart Clinic services include:

Anticoagulation Management

Heart Failure Management

Finger stick for INR testing

Immediate follow-up and assessment

Will draw other labs, if needed

Close monitoring and regular follow-up

Immediate results

Early recognition and treatment of decompensation

Immediate change in dosage of coumadin/warfarin

Medication reconciliation

Same day notification to primary and ordering physicians

Optimizing medication

Intensive education

IV diuretic as needed

Will monitor with home health draws

Intensive education

Medication reconciliation

Home management support

Close monitoring of patients INR

Referral to home healthcare/hospice, as needed

Consistent follow-up care and continuity of care

Assist in coordinating care

For more information on the Heart Clinic at Research Medical Center, call (816) 276-3892 or (816) 276-3715.

Staff Profile
Lori Spight, RN, BSN
Director of Nursing Operations
4 North/4 West

lorispight09As director of nursing operations for 4 North and 4 West, Lori Spight, RN, BSN, oversees the Cardiac, Pulmonary,Telemetry and Vascular Units. She manages the day-to-day operations of a busy 58-bed cardiac telemetry unit and a 24-bed pulmonary unit. She is responsible for budget management, making daily assignments, delegating tasks and educating new employees. 

Recently appointed coordinator of the stroke program at Research Medical Center, Lori also was instrumental in establishing unit-based Peer Review, Shared Governance and Nurse Practice Council committees to begin the journey to magnet status.

BSN - Research College of Nursing 
MHA/MBA - Fall 2010 (anticipated graduation date)

Married with four children.

What do you like most about your job?
The ability to meet new people every day.

What is your advice to others just entering the profession?
Realize that every situation is an opportunity for growth and learning. Do not limit yourself to one specialty early in your career. Explore the many options that are available to new nurses.

Proudest Accomplishment:
My four beautiful children!

Watching Lifetime and Investigation Discovery channels; attending my sons' sporting events and daughter's volleyball games.

Clinical Trials Update

Clinical trials and research have always been a big part of the Cardiovascular program at Research Medical Center. There are currently 25 open studies with an enrollment of over 400 patients. Identifying and selecting patients for these trials requires time and attention to criteria, as well as additional training in different protocols.

We will be offering a clinical research education scholarship program to those full and part-time staff who are involved in these clinical trials and research studies. Click here for more details.
Below are several clinical trials for which we are enrolling patients:

Echocardiography Guided Cardiac Resynchronization Therapy (EchoCRT)
* The EchoCRT trial evaluates the effects of Cardiac Resynchroniztion Therapy (CRT) on mortality and morbidity of subjects with heart failure due to left ventricular systolic dysfunction, already receiving optimized HF medication, with a narrow QRS width (<130 ms) and echocardiographic evidence of ventricular dyssynchrony.

SMART-AV - Comparison of AV Optimization Methods Used in
Cardiac Resynchronization Therapy

* The primary objective of SMART-AV is to assess the effect of SmartDelay for determining optimal AV delay timing during CRT compared to both a fixed AV delay and echocardiography-determined optimal AV timing chronically over a six-month period.

A Clinical Trial to Demonstrate the Efficacy of Cangrelor (PCI)
* The primary objective of this study is to demonstrate that the efficacy of Cangrelor is superior, or at least non-inferior, to that of Clopidogrel in subjects requiring PCI.

SATURN - Crestor Athero Imaging Head to Head IVUS Study
* A 104-week, randomized, double-blind, parallel group, multi-center Phase IIIb study comparing the effects of treatment with rosuvastatin 40 mg. or atorvastatin 80 mg. on atherosclerotic disease burden as measured by intravascular ultrasound in patients with coronary artery disease.

SAPPHIRE Worldwide: Stenting and Angioplasty with Protection in Patients
At High-Risk for Endarterectomy
* The primary objective of this study is to assess the outcomes of stenting with distal protection in the treatment of obstructive carotid artery disease.

For more information on these trials, visit www.clinicaltrials.gov.

Teresita Laoruangroch Honored at 
AAHFN Annual Meeting

tess2Teresita Laoruangroch, nurse practitioner in the Heart Clinic at Research Medical Center, was one of 10 scholarship winners recognized at the 2008 American Association of Heart Failure Nurses (AAHFN) Annual Meeting in Boston, Mass.

Laoruangroch also received a poster presentation award at the event for her heart failure abstract entitled: "Improving Heart Failure Core Measures Adherence." She also served as a roving reporter and her reports on "Basics of Auscultation of Heart /Sounds," "Practical Ways to Manage Sleep Apnea in Patients with Heart Failure" and "Achieving Best Quality of Care in Heart Failure" were featured in The Connection, the official newsletter of the AAHFN.