Abbott Northwestern Hospital and several regional hospitals are working together in an effort to improve treatment for people with acute aortic dissections, a deadly and difficult-to-diagnose heart condition. Through the partnership, cardiologists with the Minneapolis Heart Institute at Abbott Northwestern are available 24 hours a day to consult with physicians from regional hospitals and arrange emergency transfer to Abbott Northwestern's Heart Hospital for patients with aortic dissections.
Acute aortic dissections occur when the wall of the aorta tears. The aorta is the large blood vessel that leaves the heart and distributes blood to the rest of the body. If left untreated, the condition can cause the aorta to rupture. Once a rupture occurs, emergency open-heart surgery is needed to keep the heart pumping.
Unfortunately, many patients never make it to the operating room table. Because some aortic dissection symptoms are similar to those of a heart attack and include pain in the chest that spreads to the back or neck, sweating, confusion and nausea, the condition is often misdiagnosed. Delays in diagnosing a dissection can be catastrophic for patients; the mortality rate for people with torn aortas is one to two percent for each hour they go without surgery. Each year, 25,000 Americans die from the condition.
The most reliable way to confirm an acute aortic dissection is to have a radiologist or cardiologist, who is familiar with the condition, examine a CT scan of the patient's chest. Cardiologists at the Minneapolis Heart Institute at Abbott Northwestern treat many patients with aortic dissections each year and are highly skilled at recognizing the condition.
Under the new partnership, physicians at regional hospitals are able to leverage their colleagues' knowledge by taking a CT scan of patients they believe have a dissection. Then they can send digital images of the scan to Abbott Northwestern, where radiologists or cardiologists read the scan and determine if it is a dissection.
If it is an aortic dissection, patients are transferred by ambulance or helicopter to Abbott Northwestern's Heart Hospital. At the same time, a surgical team including a cardiothoracic surgeon, is summoned to the hospital. When the patient arrives, he or she is taken directly to the operating suite where emergency open-heart surgery is performed.
Putting in place systematic protocols to quickly diagnose the dissection and transfer the patient to the operating room has the potential to improve survival rates, according to Kevin Harris, MD, the medical director of the Minneapolis Heart Institute's Ascending Aortic Dissection Program. The Minneapolis Heart Institute is part of the International Registry of Aortic Dissection, a group of centers around the world that evaluate better ways to diagnose and treat aortic dissections.
"Getting to the operating room as soon as possible is extremely important when a patient is having an acute aortic dissection," said Harris. "By putting in place a standardized approach to care, we can improve recognition of the condition, transfer times and save more lives throughout the state."
The protocols for treating aortic dissections build upon the success of the Level 1 Heart Attack Program, a first-of-its-kind patient transfer program for heart attack patients developed through the Minneapolis Heart Institute at Abbott Northwestern Hospital. Like the Level 1 Heart Attack Program, the protocols for treating aortic dissections rely on the cooperation of health care professionals from a range of disciplines, including regional hospital emergency department personnel, medical transportation professionals, emergency department personnel at Abbott Northwestern Hospital, cardiologists, radiologists with Consulting Radiologists, Ltd., cardiothoracic surgeons with Minneapolis Cardiothoracic Surgery Consultants, anesthesiologists, nurses and others.
Regional hospitals involved in the program include Cambridge Medical Center, Douglas County Hospital in Alexandria, Hutchinson Community Hospital, Northfield Hospital, Ridgeview Medical Center in Waconia and St. Francis Regional Medical Center in Shakopee.
Minneapolis-based Abbott Northwestern Hospital is part of Allina Hospitals & Clinics, a non-profit network of hospitals, clinics and other health care services. Abbott Northwestern is found online at www.abbottnorthwestern.com.