Texas Health Harris Methodist Hospital Hurst-Euless-Bedford and physicians on the medical staff offer cardiac care services-diagnostic, laboratory and surgical-on both an inpatient and outpatient basis. Services include:
- Cardiovascular surgery, including open-heart bypass surgery
- An 18-bed Critical Care Unit
- A 23-bed Cardiac Step-Down Unit dedicated to the care of cardiac patients, in close proximity to the cardiac catheterization labs and adjacent to the Critical Care Unit
- Three cardiac catheterization laboratories for cardiac and vascular diagnostics and intervention
- Noninvasive cardiovascular testing
- Arrhythmia management and treatment
- Cardiopulmonary diagnostics
- Cardiac Rehabilitation Program
- Peripheral Vascular Disease Rehabilitation Program
Open-Heart Surgery Procedures
Coronary Artery Bypass Surgery
Also called CABG ("cabbage"), it is performed by rerouting blood around arteries clogged by plaque, fat buildup and cholesterol to improve blood flow to the heart. The narrowing of arteries by plaque, fat and cholesterol is called atherosclerosis. Atherosclerosis slows or stops blood flow through the heart's blood vessels.
Using a piece of vein from the leg, or an artery from the chest or wrist, surgeons reroute the blood flow to the heart by attaching the piece of vein above and below the blockage. This technique creates a detour around the narrowed area and restores proper blood flow and oxygen to the heart. During the surgery, patients are hooked to a heart-lung machine that oxygenates and pumps blood through the rest of the body while the surgeon works on the heart.
Adult Heart Valve Surgery
Heart valves are flap-like structures that control the direction of blood flow in the heart. Poorly functioning or diseased heart valves can be replaced with a mechanical valve, or a valve taken from a human cadaver or pig.
Aortic Aneurysm Repair
The aorta is the main artery leading away from the heart. If the aorta becomes weakened by atherosclerosis, or plaque buildup along the artery's walls, a bulge in the artery may occur. This is called an aortic aneurysm. Aneurysms are dangerous because they can burst or tear causing blood to leak into the chest cavity instead of being carried to other parts of the body. Aneurysms can also form in the lower aorta in the abdomen.
Aneurysms can be detected by X-ray, echocardiography, MRI (magnetic resonance imaging) or a CT (computed tomography) scan. Texas Health HEB provides all of these imaging services. If detected in time, aneurysms may be repaired surgically by sewing a patch or artificial piece of blood vessel over the affected area. The surgery is performed by a physician.
Carotid endarterectomy is a surgical procedure performed by a physician that involves removing fatty deposits of plaque that may be blocking one of the two carotid arteries. Carotid arteries are the main arteries in the neck that carry blood to the brain. Blocked carotid arteries can lead to a stroke, or "brain attack," as plaque built up along the artery wall obstructs blood flow to the brain.
A femoral-popliteal bypass may be needed if the femoral artery, which is the main artery in the leg, is blocked by plaque. The technique is much like the coronary artery bypass in that the procedure, performed by a surgeon, reroutes blood flow around a blocked vessel.
In the procedure, one end of a vein graft (or sometimes a man-made, synthetic vein) is attached to the femoral artery above the blockage. The other end of the vein graft is attached to the popliteal artery behind the knee to allow the blood to detour around the blockage.
Congenital Heart Defects
Some congenital heart defects are repaired by surgeons at Texas Health HEB. Congenital heart defects exist at birth and occur when the heart or blood vessels near the heart develop abnormally while a baby is still in the womb.
Critical Care Unit
Texas Health HEB operates an 18-bed critical care unit (CCU) that provides care for patients whose conditions require frequent clinical services. Most patients stay in the CCU for only a few days. Once the patient's condition improves as determined by the patient's physician, he/she is transferred to another unit. In the case of a patient who has undergone a cardiac procedure such as open-heart surgery, he/she would most often be transferred to the cardiac step-down unit.
The CCU team consists of specialty physicians on the medical staff who direct the patient's care, critical care nurses who provide nursing services, and continues with care from respiratory therapists, pharmacists, physical therapists, nutritionists, social workers, pastoral care and other ancillary personnel. The team is led by a physician on the medical staff.
For this reason, the CCU opens the unit to visitors from 9 a.m. to 1:30 p.m., 4:30 p.m. to 6:30 p.m. and 8:30 p.m. to 10 p.m. Visitors must check in with the volunteer in the waiting room before entering the unit. Occasionally, the nursing staff may adjust visiting privileges according to the needs of the patient or others in the unit.
This diagram shows an example of what a critical care room may look like and gives an explanation of the machines and tubes that may be surrounding the patient. Not every patient will use all of the tubes and machines. If children will be visiting a patient, this diagram may be helpful in preparing them.
Critical care unit room and equipment:
- Medication/intravenous fluids
- Bedside monitor that may display:
Wires and catheters connecting patient to the monitor
Air mattress aiding in skin care
Pleurovac for chest tube drainage
Pulse oximeter finger probe - reads oxygen level in the blood
Compression boots that aid in circulation
Bladder catheter and urine collector
Soft wrist restraints
Endotracheal tube (Breathing tube)
Suction and oxygen air
Pressure bag and fluid flush
- heart rate and rhythm
- blood pressure
- other pressures
- oxygen saturation
For more information about the machines and tubes surrounding the critical care patient, please feel free to ask the nurse.
Cardiac Step-Down Unit
To meet the growing needs of the community, the hospital opened a multi-million dollar cardiac step-down unit in 2002 that is dedicated to the care of cardiac patients. The 16,000 square-foot unit offers 23 private patient rooms and advance cardiac monitoring equipment, further enhancing the hospital's ability to offer quality, comprehensive cardiac care services in Northeast Tarrant County.
Physicians on the medical staff who specialize in the treatment of cardiovascular disease direct the care of patients on the CCU and throughout their stay at Texas Health HEB. For a physician referral, please call 1-877-THR-WELL (1-877-847-9355).
When seconds count, technology is vital. The cardiac step-down unit uses advanced technologies to care for cardiac patients. These technologies include:
- A wireless paging system that relays patient alarm information, vital signs and cardiac waveforms to nurses through pager-style receivers as they work throughout the unit.
- Monitors designed to move with patients throughout the hospital. The monitors match the demands of varying patient needs, acuity levels and care environments, so there is no need to change monitors and cables every time a patient is moved.
- A computerized bed featuring built-in scales for weighing and a bed frame that tilts 90 degrees so patients can sit in an upright position. The computerized tilting of the bed helps decrease stress on the patient and caregiver as well as the separation of incisions after open-heart surgery.
The unit is located on the same floor and in close proximity to the cardiac catheterization labs and CCU, further enhancing ease and continuum of care for patients, their families, and the caregivers.
Cardiac Catheterization Laboratories
Since 1999, the number of cases in the hospital's three cardiac catheterization labs has increased dramatically. This can largely be attributed to the number of interventional procedures now performed by physicians on the medical staff in the catheterization labs, including the treatment of peripheral vascular disease.
Physicians on the medical staff currently perform these procedures in the hospital's catheterization labs:
- Cardiac catheterization: A thin tube called a catheter is inserted into an artery or vein in the arm or leg and advanced into the chambers of the heart or into the coronary arteries. The test measures blood pressure and oxygen levels within the heart. It is also used to measure the heart's pumping ability. When a contrast solution is injected through the catheter into the coronary arteries during a cardiac catheterization, the test is called an angiography. The solution is visible by X-ray and is used to map the blood flow and locate blockages. The scans produced are called angiograms.
- Percutaneous transluminal coronary angioplasty (balloon angioplasty): A small catheter, with a tiny balloon at its tip is inserted into an artery in the arm or leg and navigated to the arteries of the heart. The balloon is inflated and deflated at the site of the blockage to stretch or break open the narrowing and improve the passage for blood flow.
- Coronary artery stenting: A wire mesh tube called a stent is inserted into the artery during angioplasty to keep the artery open after angioplasty.
- Intravascular coronary ultrasound: A catheter equipped with imaging devices is inserted into the body and advanced through the arteries. Intravascular ultrasound portrays the vessel from a tomographic, cross-sectional perspective, enabling direct measurements of vessel dimensions.
- Directional (DCA) and transluminal extraction atherectomy (TEC): A catheter with a rotating shaver at its end is inserted into the body and navigated to the artery with narrowing from atherosclerosis. The catheter burrs through the narrowed area and shaves off the plaque or clot. The plaque or clot is then extracted from the artery.
- Rotational atherectomy (Rotablator): This procedure is similar to DCA and TEC, however, the plaque is burred by high-speed rotation into very small particles, which are not extracted.
- Angiojet thrombectomy: A catheter that uses a jet stream of normal saline to vacuum or aspirate a fresh blood clot from the artery or vein.
- Permanent pacemaker implants
- Pain management through sedation and analgesics
- Peripheral angioplasty: Balloon angioplasty done in the peripheral arteries, or arteries outside the area of the heart (usually in the legs and lower extremities).
- Peripheral stent implants: Stents placed in the peripheral arteries.
- Vascular angiography: An X-ray examination of the blood vessels. A catheter is inserted through the groin or arm and advanced through the vessels to the vessels of interest. A special dye is injected. The fluid is visible by X-ray and an angiography is performed. Vascular angiography can be performed anywhere within the body in either the arteries or veins.
- Cardioversion: An electric shock to the chest wall by a defibrillator to restore the heart to its normal rhythm.
- Intra-aortic balloon insertion (IABP): A catheter with a balloon is inserted into the aorta that counter-pulsates with the rhythm of the heart, reducing the cardiac workload.
Texas Health HEB Hospital provides the following cardiopulmonary tests on a physician's order:
- Electrocardiogram (EKG): This test measures the electrical activity of the heart. Abnormal activities can assist the physician in diagnosing heart attack or other diseases.
- Electroencephalogram (EEG): This test measures the electrical activity of the brain and is used to detect disease processes, such as bipolar abnormalities.
- Stress test: This test stresses the heart while monitoring the patient's EKG. This is done by walking on a treadmill or by giving certain medications that stimulate the heart in order to detect abnormalities. Many times, a heart will not show abnormalities until it is exercised.
- Holter monitoring: The Holter monitor is an EKG tracing of the heart over a 24-hour time period. The patient wears the monitor to pick up changes in electrical activity during their daily activities.
- Echocardiogram (ECHO): This test takes a picture of the heart using sound waves. It detects abnormalities in the size, function and valves of the heart.
- Carotid, venous and arterial studies: These studies are similar to the ECHO and use sound waves to look at the arteries and veins throughout the body. These tests can detect abnormal blood flow through vessels.