WAILUKU - The first open-heart surgery at Maui Memorial Medical Center could be performed by this summer.
The recent hiring of a second heart surgeon and the acquisition of new medical equipment are helping the island's only acute-care hospital move closer to solidifying plans to offer help with heart disease and other related ailments. Such offerings would reduce the number of patients needing to seek cardiovascular treatment off-island because of the lack of services here.
Maui Memorial was first granted a state permit in October 2006 to expand and upgrade its vascular treatment center on its Wailuku hospital grounds. The overall plan was to build a multimillion-dollar Heart, Brain and Vascular Tower with state-of-the-art technology. But that has been temporarily scaled back because of the U.S. economic downturn and the hospital's inability to acquire more money through its investment banker, JP Morgan.
The investment firm provided the hospital $11 million last year as part of a $130 million interim and long-term financing package. Approximately half of the money was used by Maui Memorial to cover operational expenses, and the other half was given to its managing agency, Hawaii Health Systems Corp., to help other hospitals in the state.
MMMC CEO Wesley Lo said he continues to work with JP Morgan, which has advised him to wait for at least a year so that the financial climate can improve.
"It's just really hard to get" money, he said, adding that it's difficult even having the best credit rating.
While the planned Heart, Brain and Vascular Tower cannot be built anytime soon, Maui Memorial is going forward with plans to offer new cardiovascular services, including open-heart surgery.
Last month's hiring of Dr. Robert Waterford, a vascular/endovascular/cardiothoracic surgeon, follows the August 2008 hiring of Dr. Richard "Pat" Cochran, who serves as director of cardiovascular and thoracic surgery at Maui Memorial.
Cochran has mostly been involved in behind-the-scenes setup for the new cardiovascular services, but he also has been seeing patients.
Since November, Cochran's been doing general thoracic surgeries, including those involving lung cancer, benign lung disease, tumors that are deep in the chest and close to the heart, and esophageal, or throat problems.
Waterford, who began working in mid-March, is already seeing patients and said both he and Cochran are evaluating patients who may qualify for open-heart surgery.
Waterford said he feels "kind of like a pioneer" as he sees Maui patients and provides new treatments for heart-related ailments.
Waterford initially studied to be an adult cardiothoracic surgeon but has since expanded his skills and received training in peripheral vascular surgery and endovascular surgery, which involves angioplasty, stenting and other procedures to clear clogged arteries or treat aneurysms without conventional, more invasive surgery.
Waterford's skills cover treatments outside the brain involving heart, blood vessels or any structure in the chest. His practice during the last 10 years has included heart bypass, valve surgery and treatment of heart abnormalities, surgical disorders, lung cancers.
Waterford said he looks forward to the day when open-heart surgery is finally offered on Maui.
"It's one of the most exciting aspects to this whole venture," he said.
While a new tower would have been ideal to work in, Waterford said, the team approach to the development of improved cardiac services is what counts.
"It's not the facilities, but the people they have in place that will make it work," Waterford said. "I think they're doing a great job of getting people here in place."
The Maui Memorial Medical Center Foundation recently made a $420,000 donation to be used primarily for infrastructure upgrades and equipment necessary to performing open-heart and related surgeries.
Work includes retrofitting and renovation of two operating rooms, including electrical system upgrades. The job is nearly complete and should be finished this month.
There are other types of equipment that have been purchased, including a balloon pump, which keeps vessels open during open-heart surgery, and a surgical slush machine, which performs warming and cooling of fluids that go into the body; and a video flat screen and computer equipment to assist surgeons during surgery.
Items on order include a cell saver, which salvages blood, minimizing the need for blood transfusions, and a Hemostatis Management System to monitor clot formation.
"The explosive increase in cardiovascular disease throughout our nation and here at home is alarming," said Fran Peart Mitsumura, president of the Maui Memorial Medical Center Foundation.
"Our foundation is grateful for the opportunity to bring the most advanced medicine to our community in order to help curb this growing epidemic," she said. "These kinds of investments are the hallmark of our foundation's commitment to quality health care, and our ability to elevate Maui Memorial Medical Center as a center for cardiovascular excellence."
She said the foundation's success "is due, in large part, thanks to our generous donor community."
Lo said the foundation's funding support is significant.
"We are at a pivotal point in finalizing the groundwork for our open-heart program," Lo said. "With the current economic instability, having the support of the foundation has been absolutely invaluable. They will help us to reach the next stage of our cardiovascular services, giving our Maui community the necessary services to treat our citizens on-island for heart-related issues."
Maui Memorial officials estimate there are nearly 400 cases a year involving patients who had to be flown off-island for cardiovascular care and treatment. Of the 400 or so, at least half were in need of acute intervention, including open-heart surgery. The hospital's figures do not account for Maui residents or visitors who seek off-island care directly.
* Claudine San Nicolas can be reached at claudine@mauinews.com.
