Cedar Rapids hospitals ramp up their heart programs

CEDAR RAPIDS — Four years after Mercy Medical Center introduced a new heart service, the Cedar Rapids hospital has hired a second open-heart surgeon and broken ground on the Heart Center at Mercy, a new facility that will house its heart and vascular services under one roof.

Hospital officials say both steps are part of their ongoing goal to grow their heart program as patient numbers continue to climb.

Mercy has seen an 83 percent increase in inpatient office visits to its heart program since 2015, according to officials, though they declined to provide specific numbers. Patient volume “has nearly doubled” in the past 10 years, they said.

“In general, the program has done incredibly well, and it’s grown over the past decade,” said Dr. Timothy Quinn, chief of Mercy’s clinical operations.

Dr. Velu Balasubramanian, a cardiothoracic surgeon who completed his residency at the University of Iowa Hospitals and Clinics, joined Mercy in September as its second open-heart surgeon.

“It’s very exciting to be part of it from the beginning,” Balasubramanian said.

Balasubramanian, who has experience in minimally invasive and robotic thoracic surgery for lung cancer, said he hopes to grow the number of robotic procedures at Mercy.

The heart program, he said, is focused on increasing its number of patients.

As of this year, the open-heart surgical program has tallied nearly 500 procedures, officials say.

The first open-heart surgery at Mercy took place in November 2017, a year after the hospital received approval from the state certifying board to offer the procedure.

St. Luke’s opposed Mercy expanding open-heart surgeries, saying need already met locally

UnityPoint Health-St. Luke’s Hospital, which also has a cardiovascular surgical program and other heart care services, opposed the approval, saying the need for those surgeries locally already was being met.

St. Luke’s, which established its open-heart surgery program in 1978, historically performs between 275 to 300 open heart procedures a year, said Dr. Garry Weide, St. Luke’s and Physicians’ Clinic of Iowa cardiothoracic surgeon.

St. Luke’s has seen about 75 to 100 fewer cases than it would have since Mercy launched its surgical program.

However, open-heart surgery volumes also have been affected by the general trend toward newer treatment options, said Dr. Richard Kettelkamp with St. Luke’s Heart Care Clinic.

"Nationally, open heart surgeries are flat or declining as well,“ Kettelkamp said.

St. Luke’s officials cited that decline in their 2016 letter of opposition, noting national data shows technology allows procedures to be performed in a heart catheterization lab rather than a surgery suite.

Then came the pandemic, and heart surgeries among adults nationwide dropped 53 percent in 2020.

Less hospital time with less-invasive procedures

Mercy Medical heart providers also say they expect to see an increase in less-invasive procedures. Overall, patients can expect to spend less time in the hospital and see better outcomes, Balasubramanian said.

Mercy officials anticipate patient need for other heart care will continue growing — which is why the Cedar Rapids hospital invested in a new 72,000-square-foot facility to put cardiovascular services under one roof.

“We wouldn’t have gone down that path unless we were pretty confident,” Quinn said.

Over the past few decades, the number of deaths from cardiovascular disease has been on the rise globally. In 2019, cardiovascular disease accounted for one-third of all deaths worldwide, according to the National Institutes of Health.

The hospital’s new Heart Center, across the street from Mercy Medical’s entrance at Ninth Street SE and Eighth Avenue SE, is expected to open in 2023.

Dr. Ryan Hollenbeck, medical director of the Heart Center, said the building will house everything between preventive care and rehabilitation, creating a more “seamless experience” for patients.

“We’ve outgrown the space we’re at,” he said. “We’ll be able to see more patients and hire more providers in the future.”

More patients seen for ‘structural’ and preventative care

While open-heart surgical procedures are trending downward, St. Luke’s officials said their heart care services are growing, Kettelkamp said.

St. Luke’s, he added, is seeing more patients for preventive heart care “than ever before,” with cardiac providers anticipating the greatest growth in electrophysiology and structural heart care (problems with heart valves, for example).

Structural heart patient volume, in particular, is expected to grow more than 10 percent annually, Kettelkamp said.

“We are focused on continuing to advance our already robust structural heart program to better serve our community,” Kettelkamp said.

St. Luke’s officials said it also is making similar investments in the Nassif Heart Care Center, including a $5 million renovation that was completed last year.

“Long-term goals at St. Luke’s are to continue to be the heart service destination of choice for Eastern Iowans,” Kettelkamp said.

“The hospital will continue its significant investments in technology and our heart care providers will continue to innovate and bring the latest treatments, technology and research to the community.”

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