2013
Every year, more than 1 million people in the U.S. undergo cardiac catheterization—a minimally invasive procedure that allows doctors to diagnose and treat serious heart problems. The procedure is performed through a flexible catheter, or tube, that’s guided to the heart through an artery. Usually, the femoral artery in the groin is used as the access point. But a new way of accessing the heart—through an artery in the wrist—is becoming more widely offered. It's called radial access.
“Radial access greatly benefits our patients both in terms of comfort and clinical outcomes,” says Carmelo
Panetta, MD, HealthEast ® Heart
Care interventional cardiologist.
“Our team offers a high level of expertise, training and experience.”
RECOVER QUICKLY
To reduce dangerous bleeding risks, patients who undergo catheterization with femoral artery access must lie still on their back from four to six hours after the procedure. Radial access patients, however, can sit up and even walk very soon after the procedure.
Most patients are candidates for radial access. To check eligibility, your heart doctor will discuss your medical history and perform a test to determine if both arteries leading to your hand, the radial and ulnar arteries, can support the procedure.
“Radial access centers are rare in the United States but are becoming accepted as first-line rather than back-up approach,” says Dr. Panetta.
“We are proud to offer the radial center approach at HealthEast.”
LESS BLEEDING
The main benefit of cardiac catheterization through radial
(instead of groin) access is less bleeding for the patient, because the radial artery is closer to the skin. The area is therefore much easier to compress, and bleeding can be more quickly detected and treated.
The femoral artery in the groin lies deep under the skin, which can make bleeding difficult to detect and treat.
“Recent clinical studies confirmed bleeding rates are lower using radial access compared with femoral access,” says Dr. Panetta. “Two earlier studies suggested lower death rates in the setting of a heart attack if in a center focusing on radial access.”
CONNECT WITH US!
Make an appointment with Carmelo
Panetta, MD, or any of HealthEast ®
Heart Care’s other physicians, by calling 651-326-4327.
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When you’re having a heart attack, seconds count.
“The faster you get care, the less likely serious damage to your heart muscle will occur,” says Patrick Koller,
MD, cardiologist, HealthEast ® Heart Care.
HealthEast has partnered with emergency responders to reduce the time between a patient’s arrival at the hospital and undergoing angioplasty in the cardiac cath lab—known as door-toballoon time. Angioplasty is a balloon procedure, the gold standard for a serious type of heart attack known as
ST-elevation myocardial infarction (STEMI). A
STEMI is caused by a sudden blockage.
During angioplasty, a tiny balloon is inserted through a blood vessel in your groin or wrist and guided to the blocked vessel in the heart.
Once there, the balloon is inflated to open the blockage and restore blood flow to your heart.
TEAM IS ON ALERT
Paramedics and EMTs have been taught to interpret the electrocardiograms (EKGs) they administer on the scene to patients experiencing chest pain.
If emergency responders suspect you are having a STEMI, they alert the cath lab at St. Joseph’s Hospital.
“They try to provide as much lead time as possible and give the hospital an ETA,” says Amy Gallagan, RN,
HealthEast Interventional Heart Care
Clinical Director. “It gives the cath team and physician the time needed to prepare.” A HealthEast team of doctors and caregivers is then assembled. “As soon as their pagers go off, the interventional cardiologist and staff respond 24/7.”
The American College of
Cardiology recommends STEMI patients get to the cath lab within
90 minutes of their arrival at the hospital. At HealthEast, patients receive door-to-balloon care in 54 minutes or less—well below the recommended time, Dr. Koller says.
FASTER CARE MAKES
A DIFFERENCE
HealthEast’s ER staff has also been trained to help patients complaining of chest pain within five minutes of their arrival. If staff members recognize signs of a
STEMI, patients are immediately transported to the cath lab.
Faster care for STEMI patients can also mean fewer deaths from heart attacks, fewer strokes and shorter hospital stays.
“With these preparedness procedures,” Dr. Koller says,
“we have improved the outcomes of STEMI patients we treat and are able to lessen the impact of injuries when they occur.”
WHAT ARE THE SYMPTOMS OF A HEART ATTACK?
Get a complete list of heart attack symptoms from the American
Heart Association. Go to www.heart.org and click on the red
“The Warning Signs” tab.
2 HealthEast | The Heart of the Matter

When your arteries can’t supply to the blocked arteries that require enough blood to your heart, your doctor may recommend an openheart procedure known as coronary artery bypass graft (CABG).
Traditionally, doctors had to stop the heart to perform this procedure, and the patient had to be placed on a heart-lung machine that continued to pump blood.
But thanks to advances in technology, HealthEast ® Heart Care surgeons can now perform CABG surgery without stopping the heart.
This is called beating heart, or offpump, surgery.
“When you have a team of cardiologists and anesthesiologists like ours, who are experienced and capable, off-pump is a great way to go," says David Joyce, MD,
HealthEast cardiovascular surgeon.
During CABG surgery, a positioning system holds your heart still so the surgeon has easy access bypassing with new vessels. The surgeon sews a healthy blood vessel to your heart above and below the blocked arteries. Blood flow is then rerouted.
Patients who undergo off-pump heart surgery generally need less blood transfused and are at a lower risk for bleeding. “Because you’re not manipulating the aorta, the largest artery in the body, your stroke risk is lower, too,” Dr. Joyce says.
Plus, off-pump patients recover faster, because they don't have to be hooked up to a heart-lung machine and then weened off it, Dr.
Joyce says. “So, people go home from the hospital a little sooner.”
Beating-heart surgery isn’t for everyone, says Dr. Joyce. It depends on the location of the artery that needs bypassing. But
“if your anatomy allows for it, it’s a very good option to have."
WANT TO KNOW MORE?
Take control over your cardiovascular health by calling HealthEast ® Heart
Care at 651-232-4500, or visit healtheast.org/heartcare/heart-surgery/cabg.
Trail mix is not only a flavorful snack, it can be heart-healthy too. Research suggests that eating about 2 1/2 ounces of nuts per day can decrease “bad” cholesterol levels.
Ingredients
1 cup wheat cereal
1/4 cup dried fruit (raisins, blueberries, cranberries, chopped apricots, plums, peaches, or a mixture)
1/4 cup cashews (or other nuts)
Directions
Mix ingredients, split into two servings and store in sandwichsize plastic bags.
Nutrition Facts
Each serving contains about
192 calories; 5 g protein; 9 g fat;
28 g carbohydrates; 3 g fiber;
115 mg sodium.
HealthEast | The Heart of the Matter 3

HealthEast ® Heart Care:
651-326-4327
1-855-271-2328 (toll-free) www.healtheast.org/heart
HealthEast
1700 University Ave.
St. Paul, MN 55104
NON-PROFIT ORG
U.S. POSTAGE
PAID
HEALTHEAST
10604M
Sometimes trouble comes in twos — like diabetes and heart disease. If you have one of these conditions, you may be at risk for the other.
Diabetes can lead to heart disease.
People with diabetes are twice as likely to develop heart disease than those without it. “High blood sugar levels damage the body’s blood vessels, causing them to narrow and form blockages,” explains
Les Forgosh, MD, FACC, FACP,
HealthEast ® Heart Care cardiologist.
“This increases the risk for heart attack and stroke.”
On the other hand, heart disease can increase diabetes risk. Dr. Forgosh says heart disease is a common cause of heart failure, in which the heart is weak and can’t pump enough blood.
People with heart failure could be at higher risk for diabetes, as researchers think heart failure changes the way the body uses insulin—leading to excess glucose in the blood.
Obesity, inactivity and an unhealthy diet can set the stage for developing both heart disease and diabetes. High blood pressure, elevated cholesterol and smoking also raise the risk for both diseases.
“It’s common to have both diabetes and heart disease,” says
Dr. Forgosh. “The good news is that reducing these shared risk factors with healthy lifestyle changes can help manage both problems.”
HEALTHEAST ® IS HERE FOR YOU
HealthEast ® Heart Care has resources to help you manage your health. For information about preventing heart disease, call our
Ways to Wellness team at 651-326-4327 or visit healtheast.org/ heart and click on "Cardiac Prevention Program." For more about diabetes prevention, call our diabetes educators at 651-232-5757 or visit healtheast.org/diabetes.
If you have type 2 diabetes and have had a heart attack or stroke, you may be eligible for a Phase III clinical trial testing a new diabetes drug.
“We are investigating whether this new drug effectively treats diabetes and is safe for people with cardiovascular problems,” says Andrew Snyder, MBA,
FACMPE, PMP, HealthEast ®
Heart Care Director of
Research.
Les Forgosh, MD, is acting as principal investigator for the study, which will involve
5,000 patients worldwide who will be followed for two to six years. Dr. Forgosh is currently enrolling patients; to learn more or participate, call 651-326-4448.
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