Operating Rooms Dedicated Solely to Cardiac Implants
By Alfredo Arango
Pacemaker and defibrillator implants have become so important that the most advanced hospitals are building special operating rooms for the sole purpose of performing these procedures.
Experts assure that this measure benefits cardiac patients, who constitute the largest number of fatalities in the United States. According to the American Heart Association, cardiovascular diseases take more lives than the next seven main causes of death combined, including cancer, accidents, influenza, pneumonia and diabetes.
“We are very excited about the new development of operating rooms dedicated solely to implanting cardiac devices. This change reflects the great demand for standard pacemakers and new defibrillators. The idea behind these dedicated operating rooms is the search for excellence in these procedures. They also include a staff completely dedicated to this specific type of cardiac care, making it possible to streamline the procedures and be extremely efficient, which, in turn, benefits the patients,” says Dr. Joseph Zebede, an electrophysiologist affiliated with Aventura Hospital and Medical Center. Electrophysiology is a branch of cardiology that deals with conditions involving the heart’s electrical system, such as arrhythmias, sudden cardiac death and congenital abnormal rhythms, among others.
The specialist states that another advantage for the patient is the fact that these interventions are carried out in an environment in which only cardiac procedures are performed, not any other types of surgery. “From the infection point of view, these dedicated operating rooms are probably a bit safer. Each of the patients undergoing surgery comes into the room without any infection. In theory, the risk of infection is nonexistent because there are no organisms in the environment,” Dr. Zebede adds.
In any case, the new operating rooms dedicated exclusively to cardiac implants follow the specifications of a regular operating room.
“In these implant rooms, as in any other surgical environment, positive air pressure and a flow of fresh air are needed to remove contaminants that could possibly be in the room, by causing them to circulate. This prevents the presence of bacteria, thereby reducing the risk of contamination. It is one of the many precautions taken,” explains Susan Mableson, head of infection control at the same hospital center.
These cardiac implant surgical rooms are equipped with a system called a C-Arm, which makes it possible for the surgeon to visualize the surgical field on a monitor. Philips, one of the companies manufacturing this technology, explains that the new versions of this type of equipment are portable and present larger monitors with better resolution, making it possible to view more details at the time of examination or surgery.
The implant rooms have a special adjacent room in which the patient is prepared before the procedure and taken care of immediately after surgery; in other words, it serves as a recovery room. From there the patient is taken to the post-op care unit to recover completely and go home the same day or the next, depending on his/her condition,” explains Clemencia Silk, head of cardiovascular services at Aventura Hospital.
Though minimal, there is a possibility of complications occurring while implanting a cardiac device, therefore making it necessary to resort to an open surgical procedure. For this reason, the law requires that an operating room and a cardiovascular surgeon be available near the implant rooms.
The pacemakers and defibrillators implanted in these operating rooms are very small devices that fit in a closed fist, and they are used to correct certain electrical problems of the heart. The main difference between them is basically that pacemakers keep the heart beating at a proper rate by detecting arrhythmias and sending electrical signals to the heart to regulate, little by little, the frequency at which it beats; whereas defibrillators detect tachycardia and shock the heart to bring it back to a normal rhythm.
Technological advances make it possible for these implant procedures, which take about two to three hours, to be much less invasive than in the past, since they no longer require open surgery.