Fixing New Mexico's Broken Hearts

Dennis Domrzalski, Reporter- Albuquerque Business First

The New Mexico Heart Institute attracts the best by being the best.

Deanna Kyrimis, CEO of the New Mexico Heart Institute, says an emphasis on research has helped attract doctors.

They’ve come from Duke, Stanford, Harvard, the Cleveland Clinic, the University of California and all over the U.S. to work in Albuquerque.

They’re doctors, researchers and other health care professionals who have come to the Duke City for the opportunity to work at the New Mexico Heart Institute, an independent physician practice that has been providing New Mexicans with cutting-edge care and research for more than 40 years.

Since it began in 1971 when Dr. Jerry Goss started a practice in Albuquerque, the Heart Institute has followed its founding principles; to provide innovative clinical care, engage in research to advance the practice of heart care and to provide education for its doctors and for the community.

Now in its 44th year, the Heart Institute is providing New Mexicans with care they can’t get anywhere else in the state. In 2013 the practice had three “firsts” in the state in terms of cutting-edge procedures. It is engaged in 22 ongoing clinical trials and it helps educate doctors from around the nation.

And in 2014, the Heart Institute hopes to add to its presence in other communities in the state by opening at least one more clinic.

NMHI’s Dr. Sean Mazer said the practice boosts Albuquerque’s economy by attracting top talent from around the country.

“Every time we recruit a new doctor into the community they bring a spouse and kids, they bring with them their own little community of people who are valuable,” Mazer said. “Three of our physicians have wives that are professors at the University of New Mexico in the medical school. That makes a concrete difference. It’s a real engine of recruitment and retention of really amazing people to New Mexico. Anything to fight the brain drain.”

Mazer also said the practice has learned a lesson that any company in New Mexico could apply: in order to attract top talent, firms must strive to do the best and most innovative work possible.

The research arm of the practice is a cooperative effort with the Duke University Cooperative Cardiology Studies program that’s comprised of 100 cardiology practices in the U.S.

“We keep research here in New Mexico and that allows our doctors to offer life-saving techniques and the ability to advance medicine,” said NMHI CEO Deanna Kyrimis. “It’s part of our passion to do medical research and to offer patients life-saving treatments that they can’t get elsewhere. And that helps us to be able to attract the best people.”

NMHI’s Dr. Brendan Cavanaugh agreed that doing and providing cutting-edge research and care helps attract the best talent to the practice.

“Our group has decided that we are not going to be passengers, we are going to be drivers” when it comes to advancing heart care, Cavanaugh said.

For Mazer, president of the practice’s board of directors, the organization’s independence is one of the things that attracts the top talent.

The practice is fully and equally owned by its doctors and it intends on staying independent.

“I think one of the things that people are attracted to is our sense of mission that puts the patient first,” Mazer said. “People are attracted to the energy and the feeling that we have here. There is a sense of early adoption, and the people who work here want to be ahead of any change in their industry.

“And there is an ongoing trend in our industry toward employment of physicians rather than the physicians remaining independent, and the sense of independence that our doctors have is unique.”

In 1998, the Heart Institute partnered with MedCath Corp. of Charlotte, N.C., to build the 50-bed Heart Hospital of New Mexico.

“We felt the model of a heart hospital would be the future because of the highly specialized care that is required for patients,” said Dr. Barry Ramo, who joined the practice in 1972.

But Congress passed the Affordable Care Act in 2010, and the new law said doctors couldn’t own hospitals. So in 2011, the hospital was sold to Lovelace Health System.

As part of the sale, the Heart Institute and its doctors help co-manage the hospital, which is now called the Heart Hospital of New Mexico at Lovelace Medical Center.

Troy Greer, CEO of Lovelace Medical Center, said the partnership is working well.

“It’s a wonderful relationship. It’s the only cardiovascular hospital in the state, and working together results in the best care for patients,” he said.

Heart Institute doctors and Lovelace officials are working on plans to build a combined cath lab and operating room at the hospital, a project that will cost “millions,” Greer said.

Construction could start in the first quarter of 2015, he added.

By the numbers:

  • $30 million - Annual revenue
  • 220 - Employees
  • 60,000 - Patients
  • 22 - Ongoing clinical trials
  • Source: New Mexico Heart Institute

Abdominal surgery’s now less of a stomachache

Normally, patients with ruptured abdominal aortic aneurysms face a grisly three-to-six-hour operation in which they are gutted, their insides set aside and the ruptured artery repaired with a stent.

Then they face a 10-day hospital stay and weeks of rehabilitation.

No more.

In 2013, Dr. Steve Henao of the New Mexico Heart Institute repaired a ruptured abdominal aortic aneurysm in about 20 minutes and with a minimally-invasive surgery. The procedure was wrapped up in an hour, and in two days, his 82-year-old patient was out of the hospital and back at home.

It was the first surgery of its type in New Mexico, and the first in the U.S. with a new stent that had been approved by the U.S. Food and Drug Administration just months earlier.

“This is a new paradigm shift in how this disease is treated. It’s a move away from gigantic belly surgery to a minimally-invasive procedure,” Henao, an endovascular surgeon, said. “I’m convinced that this is the way technology is going to be in the future. The guy walked out of the hospital in two days. It’s one of those stories you don’t hear enough of. This is a real game changer.”

The stent was threaded through the patient’s leg artery to the aortic artery and put into place.

Clinical trials play key role

Tired of wondering whether your pacemaker is working properly and having to go into the doctor’s office or hospital to find out?

Well, in the future you might not have to, thanks to a clinical trial being conducted by the New Mexico Heart Institute. The study is looking at the effectiveness of a device that allows doctors to determine remotely whether a pacemaker is working properly.

“The device has never been used in New Mexico and we are trying to demonstrate it and determine if it can save patients huge amounts of energy and money,” said Dr. Sean Mazer, president of the NMHI board of directors.

Patients routinely wonder whether the devices are working properly, and if they live in rural areas of the state, that could mean getting into a car or on a bus to go to Albuquerque or another city with a hospital.

The Heart Institute is currently involved in 22 clinical trials, Mazer said.

An alternative to blood thinners

In 2013, the New Mexico Heart Institute and the Heart Hospital of New Mexico at Lovelace Medical Center came up with another first for New Mexico.

Dr. Ross Downey performed the first procedure in the state to control atrial fibrillation, the most common heart rhythm disorder.

Normally, the condition, which accounts for 20 percent of stroke-related deaths a year, is treated with blood thinners. But blood thinners can lead to fatal bleeding episodes, and one anticoagulant, warfarin, is the main ingredient in rat poison and patients don’t like taking rat poison.

Downey used the LARIAT Suture Delivery Device to tie off an appendage of the heart that causes the fibrillation. The tied-off part eventually shrivels away and the patient doesn’t need blood thinners.

“Our mission is to provide cutting-edge, high-quality cardiovascular care to our patients and the LARIAT ‘lasso’ is another example of our commitment to this mission,” Downey said.

The procedure involves guiding two catheters underneath the breastbone into the patient’s heart. One catheter contains a pre-tied suture loop that’s similar to a lasso. It is slipped around the appendage, tied off and the appendage turns into scar tissue over time.

“LARIAT is a better option for people who can have it and don’t need to be on blood thinners the rest of their lives,” said Dr. Robert Federici of the Heart Institute.

Bringing stents into new types of procedures

For years, stents coated with drugs have been used in heart surgeries and to repair arteries.

Now, New Mexico Heart Institute doctors are using them to prevent amputations and save legs.

In October 2013, Dr. Steve Henao performed the first limb-saving drug-eluting stent placement at the Heart Hospital of New Mexico at Lovelace Medical Center. Since then, he has placed 87 drug-coated stents in patients.

The new stent is called the Zilver PTX and it uses a proprietary coating of Paclitaxel, a drug that inhibits cell division originally used in the treatment of cancerous tumors. The drug coating can slow the natural healing response around the stent, and reduce the chances of renarrowing, Henao said.

The limb-saving surgery was one of many firsts that NMHI doctors performed in 2013.

In addition, the Heart Institute is involved in nearly two dozen clinical trials. One of those trials will involve manipulating the kidneys to control high blood pressure.

“We have a great tradition of being forward-thinking,” said Dr. Mark Bieniarz.


To see this story in print, click here.

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