Ministry Saint Joseph’s Hospital
All aspects of Ministry Saint Joseph's Hospital’s award-winning heart care program underscore a commitment to compassionate care and clinical excellence. Through our partnership with the Marshfield Clinic, we offer comprehensive heart care including prevention, education, diagnosis and treatment to recovery and rehabilitation following surgery or a less-invasive heart procedure.
Our cardiac surgeons use the most advanced procedures in open heart surgery, including off-pump techniques and extensive use of internal mammary artery grafting, which contribute to our exceptional patient outcomes.
Ministry Saint Joseph’s Hospital is also an advanced care center for the Rescue1 program, a life-saving system of rapid transfer and treatment of heart attack patients from across Central and Northern Wisconsin.
You may schedule an appointment to consult with a heart care specialist by calling 800-888-4755.
The following procedures are often used in the evaluation and treatment of cardiovascular disease. Consult your physician or heart care professional for more specific information.
Cardiac Procedures for Abnormal Heart Rhythms
This procedure uses radio waves to silence an abnormal area in the heart electrical system, which is usually found during an electrophysiology study.
A permanent pacemaker is inserted into the patient's heart and upper chest to provide a reliable heartbeat when the heart's own rhythm is too fast, too slow, or irregular. A permanent pacemaker is usually inserted while the patient is in the electrophysiology lab.
Internal Cardioverter Defibrillator
A defibrillator is inserted into the patient's heart and chest to send out a small amount of electricity when needed to jolt heart rhythm back to normal.
An innovative surgery called the Maze procedure has proven highly successful in curing atrial fibrillation.
Cardiac Procedures for Heart Disease
With this procedure, a catheter is used to create a bigger opening in the vessel to increase blood flow. Although angioplasty is performed in other blood vessels, Percutaneous Transluminal Coronary Angioplasty (PTCA) refers to angioplasty in the coronary arteries to permit more blood flow into the heart. There are several types of PTCA procedures, including:
- balloon angioplasty
- laser angioplasty
- coronary artery stent
- TEC catheter
Open Heart Surgery
Open-heart surgery is performed on the heart while the bloodstream is diverted through a heart-lung machine. The surgery includes heart valve replacements, coronary artery graft (CABG) surgeries, heart transplants and "other open-heart procedures."
Coronary Artery Bypass Grafts (CABG)
A surgical procedure in which small portions of veins or arteries are taken from one part of the body and transplanted into the heart to bypass clogged coronary arteries in the heart.
In this surgical procedure, a mechanical or tissue valve is transplanted into the heart to replace the damaged valve.
Transmyocardial Revascularization (TMR)
The procedure, called Transmyocardial Revascularization, or TMR, uses laser surgery to create small holes directly into the heart muscle to relieve chest pain. Angina occurs when blood vessels, which bring blood to the heart muscle, are clogged or damaged. When this happens, the heart muscle doesn't get the oxygen it needs and patients feel pain, called angina, in their chest, neck, jaw or shoulders. This pain can often severely limit their physical activity and ability to do the things they want to do. The procedure takes about 90 minutes, and involves a small incision on the left side of the chest. A bypass machine is not needed, and blood thinners are not used during TMR. For certain patients needing bypass surgery, TMR can be used in areas of the heart where bypasses cannot be placed. This can improve the results of the surgery.
Valvuloplasty is a procedure in which a catheter with a large balloon is used to open a heart valve that has become narrowed usually as the result of scarring. The catheter is guided through the aorta to the valve, and once in place within the leaflets, the balloon is inflated until the leaflets are loosened. The balloon is then deflated and withdrawn from the body.
Pediatric Heart Care
Through our partnership with the Marshfield Clinic Pediatric Cardiology program, Ministry Saint Joseph’s Children’s Hospital offers evaluation and management of murmurs, structural heart diseases, heart rhythm disturbances, chest pain, dizziness/syncope and heart failure.
Cardiology services also include the evaluation of the fetal heart and preventive cardiology and management of hyperlipidemia, hypertension and obesity. Cardiovascular surgery is also available.
Cardiac Rehabilitation in Marshfield
Cardiac rehabilitation is a physician-supervised program for people who have either congenital or acquired heart disease. Program participants may or may not have had a heart attack or heart surgery (or other heart procedures). Cardiac rehabilitation can often improve functional capacity, reduce symptoms, and create a sense of well-being for patients. A physician may prescribe cardiac rehabilitation for a patient in certain situations.
Conditions or cardiac procedures that may necessitate cardiac rehabilitation may include, but are not limited to, the following:
- congestive heart failure
- angina pectoris
- myocardial infarction
- post-open heart surgery
- post-heart transplantation
- balloon angioplasty
- congenital heart disease
- rheumatic heart disease
Cardiac rehabilitation programs can be conducted while a person is a hospital inpatient or on an outpatient basis. Many skilled professionals are part of the cardiac rehabilitation team, including any/all of the following:
- cardiologist / cardiovascular surgeon
- rehabilitation nurse
- physical therapist
- occupational therapist
- speech / language therapist
- psychologist / psychiatrist
- recreational therapist
- vocational therapist
A cardiac rehabilitation program is designed to meet the needs of the individual patient, depending upon the specific heart problem or disease, and should be supervised by a cardiac physician and a team of cardiac professionals. The goal of cardiac rehabilitation is to help patients reverse their symptoms and maximize cardiac function. Cardiac rehabilitation includes, but is not limited to:
- develop an exercise program
- be knowledgeable about their risk factors
- learn about their heart condition
- be prepared for recovery at home
New and advanced diagnostic tests and tools are constantly being introduced to further understand the complexity of disease, injury, and congenital or acquired abnormalities. The following are just a few of the diagnostic tests that have been used/are being used to further understand and identify cardiovascular disease. For more specific information, consult your cardiologist or physician.
Electrocardiogram (ECG or EKG)
A test that records the electrical activity of the heart, shows abnormal rhythms (arrhythmias or dysrhythmias), and detects heart muscle damage.
Signal Average Electrocardiogram (SAE)
A test that is much like an EKG, but takes longer because it records more information.
Stress Test(usually with ECG; also called treadmill or exercise ECG)
A test that is given while a patient walks on a treadmill to monitor the heart during exercise. Breathing and blood pressure rates are also monitored. A stress test may be used to detect coronary artery disease, and/or to determine safe levels of exercise following a heart attack or heart surgery.
Echocardiogram (also known as echo)
A noninvasive test that uses sound waves to produce a study of the motion of the heart's chambers and valves. The echo sound waves create an image on the monitor as an ultrasound transducer is passed over the heart.
A test in which a small transducer is passed down the esophagus to provide a clearer image of the heart structure.
Positron Emission Tomography (PET) Scan
A nuclear scan that gives information about the flow of blood through the coronary arteries to the heart muscle.
Myocardial Perfusion Study
This Nuclear Medicine Scan can be used to determine whether a person has a blockage or narrowing of the arteries that feed the heart muscle. It can also be used as a follow-up to other procedures such as an angiogram or cardiac bypass surgery.
Resting Myocardial Perfusion Scan
A radioactive isotope is injected into a vein in the patient's arm. This material concentrates within the muscle of the heart. Images are then taken, showing the areas in heart that is receiving adequate blood flow via the coronary arteries. This serves as a baseline for the exercise portion of the study.
Exercise Myocardial Perfusion Scan
The radioactive isotope is injected into a vein during exercise testing on a treadmill. Once a person's heart rate is increased, a blockage will cause a decrease in concentration of the isotope in the heart muscle. Nuclear imaging is done following the completion of the stress test.
Pharmaceutical Myocardial Perfusion Scan
When a person cannot exercise, a pharmaceutical stress test may be substituted for the exercise portion of the test. Adenosine and Dobutamine are the medications that are used to simulate the affects of walking on a treadmill. During the stress test the radioactive isotope is injected into the person's vein. A blockage will cause a decrease in concentration of the isotope in the heart muscle. Nuclear imaging is done following the completion of the stress test.
Resting Gated Blood Pool Scan or MUGA
The nuclear scan taken, while the patient is at rest, to measure the percentage of blood going through the heart with each beat.
Exercise Gated Blood Pool Scan or MUGA
The nuclear scan taken, while the patient is exercising, to measure the percentage of blood going through the heart with each beat.
Thallium Vialility Scans
This cardiac imaging is to confirm viable cardiac tissue. This may be used to determine whether a person would benefit from coronary bypass grafting or a heart transplant. The person is injected with a radioactive isotope and imaging is done after thirty minutes. This exam also consists of delayed imaging which often includes four hour post injection and twenty-four hour post injection.
A small, portable, battery-powered ECG machine worn by a patient to record heart beats on tape over a period of 24-48 hours -- during normal activities. At the end of the time period, the monitor is returned to the doctor's office so the tape can be read and evaluated.
A small, portable, battery-powered machine used by a patient to record ECG over a long period of time. Patients may keep the recorder for several weeks. Each time symptoms are experienced, the patient presses a button on the recorder to record the ECG sample. As soon as possible, this sample is transmitted to the doctor's office by telephone hookup for evaluation.
Tilt Table Test
A test performed while the patient is connected to ECG and blood pressure monitors and strapped to a table that tilts in different directions. This test is to determine if the patient is prone to sudden drops in blood pressure or slow pulse rates.
A test in which insulated electric catheters are placed inside the heart to study the heart's electrical system.
During the test a local anesthetic is given and a small puncture is made, usually in the groin or arm. A small catheter (hollow tube) is guided through a vein or artery into the heart. An iodine compound (a colorless liquid "dye") is given through the catheter, and moving x-ray pictures are made as the dye travels through the heart. This comprehensive test shows: narrowings in the arteries, outside heart size, inside chamber size, pumping ability of the heart, ability of the valves to open and close, as well as a measurement of the pressures within the heart.
Coronary Arteriogram (or Angiogram)
With this procedure, x-rays are taken after a contrast agent is injected into an artery -- to locate the narrowing, occlusions, and other abnormalities of specific arteries.
One patient described it "like a bunch of scared bullfrogs in a bag inside my chest that were trying to jump out."
It's Atrial Fibrillation, (AF) an abnormality of the electrical systems of the heart. One of the most common irregular heart rhythms, it affects more than 2.2 million people in the United States. Symptoms can include heart palpitations, lack of energy, dizziness, chest discomfort and shortness of breath.
Left untreated, chronic AF can increase the risk of stroke, heart failure and even death. Fortunately, several treatment options are available, including medications and lifestyle changes. When those do not work, procedures such as electrical cardioversion or catheter ablation are often successful in alleviating symptoms. But they aren't effective for everyone. Some patients are so uncomfortable when they're in atrial fibrillation, or suffer such adverse side effects from the medications to treat the condition, that surgical intervention is needed.
The good news is that for these patients, an innovative surgery called the Maze procedure has proven highly successful in curing atrial fibrillation.
According to Paul Pearson, MD, Marshfield Clinic cardiovascular surgeon on staff at Ministry Saint Joseph's Hospital, the Maze procedure involves a series of precise incisions made in the atrium of the heart to create electrical barriers and specific pathways for electrical activation of the heart. This allows for only one major route for an electrical impulse to travel through both atria of the heart—hence the term "maze." Ministry Saint Joseph's Hospital is one of only a few hospitals in Wisconsin offering the procedure.
"The Maze procedure is an open heart procedure, so it's only considered when other treatment methods have failed," said Dr. Pearson. "The procedure can also be performed in conjunction with other cardiac surgical procedures. In a recent case, the patient needed open heart surgery to replace an aortic valve, and we were able to use the Maze procedure to cure his longstanding AF as well."
Hospital stays after the procedure are generally 7 days, with compete recovery within six to eight weeks. Published results for the procedure have been impressive.
"The Maze procedure was first developed in the 1980s, and studies show that the procedure has a cure rate of up to 90 percent for longstanding atrial fibrillation," said Dr. Pearson. "Symptoms are eliminated and patients experience a lower incidence of stroke and blood clots. For AF patients, it can significantly improve their quality of life."