Episode Transcript
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Speaker 1 (00:01):
Mix one oh six ' five. Good morning, It's Christina Wolford.
It is time for Lady Parts with doctor Richard Villarreal
of Adina Obgyan. Good morning, doctor Villarreal. I'm doing great.
Speaker 2 (00:13):
How about you doing well?
Speaker 1 (00:15):
So it is time for another Lady Parts show. We
do this once a month thanks to Adina talking about
issues impacting women's health and sometimes men and women's health
together and we kind of have that. Today we have
a special guest in here today. Would you like to
introduce him?
Speaker 2 (00:28):
Sure? Today I have doctor to Will and he is
now the new medical director for the Cardiothoracic Surgery Center.
So I'm very excited about this. Doctor Twill has over
thirty years of experience that he brings to aDNA. I'm
very excited that he can't earn his medical degree from
the American University in Beirut. He completed his residency in
(00:52):
North Carolina Memorial Hospital in Chapel Hill. He did a
fellowship at the University Hospitals in Cleveland. He most recently
comes from Memorial Hospital and where he opened a heart
program in twenty twenty. So he has a lot of
experiences bringing to us and we're very excited about this.
So doctor, we're going to just talk a little bit.
Speaker 3 (01:12):
Start.
Speaker 2 (01:12):
Let's talk a little bit about you. What led you
to pursue a career in cardiothoracic surgery.
Speaker 4 (01:19):
Good morning.
Speaker 3 (01:20):
First of all, I think you're mostly influenced by the
physicians you work with during medical school training and later
on in fellowship. I was extremely impressed by the cardiothoracic
surgeons I worked with, both in Chapel Hill, North Carolina,
as well as at the University Hospitals in Cleveland, and
(01:41):
I thought, well, you know, at the beginning, I thought
I wasn't so sure whether it be in general surgery
or go to cardiothoracic surgery. But I thought I'd make
a difference more in cardiothoracic surgery.
Speaker 4 (01:53):
I'll take that.
Speaker 3 (01:54):
So I just chose that because of thinking that I
really will be able to have more in that particular specialty. Plus,
it's a very clean cut specialty. A lot of it
has to do with rhythm. It's I think mathematical in
many ways, and that really appeals to me.
Speaker 2 (02:14):
So wonderful. So what led you? So You've You're you're
bringing a lot of experience with DINA and that's you
presented to the physicians. You guys, you talked about what
you're doing, and we were so impressed and we thought
this would be wonderful sort of get this out to
the community about all the experience that is now at
a dina. And so what led you to come here.
Speaker 3 (02:35):
I had started a program in Marietta, actually in Ohio also,
and I saw this opportunity open up here because the
program was passed for a short time and everybody had
to make sure that the re launch would be very
well studied and examined and every step is properly taken.
(03:00):
So I thought, well, maybe there's a chance that I
can relaunch this program, and I helped relaunch it. So
I came here and basically it was the effort of
so many departments, of so many people, everybody working very hard,
and you know, meeting after meeting that went on and
on and going over every detail that really should be covered.
(03:25):
And at that point this was sent, you know, to
the High Department of Health and the program was relaunched, which.
Speaker 2 (03:34):
Is wonderful for Adena and all the people in this community.
So you mentioned the recruitment that you know, you had
to find the right additions to the team, both heart
and vascular leadership changes, facility and equipment enhancements I know happened.
So what does that mean for the patients.
Speaker 3 (03:54):
Well, first of all, I had checked about, you know,
the Adena health system here and and this was really
something I did with the cardiologist. Above all, the most
important thing is to have the proper people and then
the equipment.
Speaker 4 (04:11):
Uh.
Speaker 3 (04:11):
The cardiologists are a very good team here, definitely. They
all work very well with each other. They are everybody
is supportive and without their help and support, obviously you
can't have a cardiac program. You have to have cardiologists
to actually evaluate the patients and send them to surgery.
Speaker 4 (04:31):
So I checked about that before.
Speaker 3 (04:32):
I came, and and this was mainly the effort of
doctor Musa Musa, who is the uh the chief cardiologist here.
So at the same time I had found out more
from him about what the area was like, uh, the
need for cardiothoracic surgery, what the facility was like, and
(04:58):
you know, I found out that, you know, there are
three critical care hospitals that feed into the main hospital.
There was open heart before, definitely for many many years,
and everybody was quite experienced in that a lot of
the people who worked in open heart have been doing
it for many years.
Speaker 4 (05:19):
The equipment was certainly up to date.
Speaker 3 (05:22):
There is also what you call a hybrid room. Hybrid
room is a room which can be used both as
an operating room as well as a room where you
can do cardiology procedures in other words, cardiac characterizations, stents, interventions,
and also taver taver, which is a placement of aotic
(05:47):
valves through the groin into the area of the heart
where they should go. You know, the hybrid room is
a multimillion dollar room, which you know, which is which
everybody wants to have. And this is an up to
do you know, a state of the art room, and
definitely you know, there's.
Speaker 4 (06:05):
You know, we just used it today.
Speaker 3 (06:06):
Actually it's certainly a place that we'd like to work
at the same time, you know. Leading to relaunching the
open heart program, we had to go through various what
you call mock up.
Speaker 4 (06:24):
Trials where you go through an.
Speaker 3 (06:26):
Actual procedure without a patient and go through every step,
make sure every step is examined, and we did several
of those. Every time you do it, you find something
that you really have to make sure is a fool
proof and this is what we did, and this is
really the work of so many departments besides cardiology, the
(06:47):
operating room and sociologists. The profusion is to run the
heartline machine, which is essential for this procedure, the open
heart procedure, as well as the intent ensive care unit.
There's a brand new intensive care unit now and the
nurses are extremely experience They've done this for a long
(07:07):
time and the hearts that we have done so far,
you know, within the past two months, have been taken
care of very.
Speaker 4 (07:15):
Well by this group of nurses. So it's a lot of.
Speaker 3 (07:18):
Planning, a lot of evaluation, a lot of revision of things.
Still you get to the point where you can present
the product at the end. And the Department of Health
in Columbus has agreed to relaunching the program, which is
what we have done, and we have done several cases
so far and everything has been very well so far.
Speaker 2 (07:43):
Well that's exciting to hear. So, you know, I'm interested
a little bit exase I don't know much about the
cardiovascular health and so I was really interested in this
hybrid operating room and so how does that enhance care?
So I mean I know, it's a multimillion dollar area,
multimion dollars and this is the state of the art,
and everybody wants to have something like this. But why.
Speaker 3 (08:07):
A hybrid room is very useful because it can act
as like I said, an operating room as well as
a room where you can do cardiac procedures like stents
and in angioplasty and putting implants like what they put
for what you call aight refibrillation. You can put watchmen devices,
(08:28):
you can put defibrillators, you can put pacers.
Speaker 4 (08:33):
This is good because this room, first of all, is large.
Speaker 3 (08:38):
You can put all the equipment you need in one room.
It has anesthesia like an operating room. It also has
all the possible wires and stents that you can use
if you are doing a stent or a balloon for
a patient. And in those situations like sometimes invascular situations
(08:59):
where you are trying to do something and put a
stent and it doesn't work or the stent is not
the optimal thing and you want to convert and make
the procedure and operation, all you have to do is
keep the patient where it is. Anesthesia is right there,
and the procedure changes from a stent to an open
(09:20):
operation and you can complete the surgery there and without
moving the patient anywhere, and you minimize the amount of
anesthesia of course, and transfer the patient following that.
Speaker 4 (09:34):
To recovery or to the ICU.
Speaker 3 (09:36):
So it's a very convenient way of dealing with a
problem that can go either way. Or if you are
dealing with a bigger problem like you're doing, you know,
any kind of aneurism extent for an aneurism, if that
is going to change to an open procedure, you stay
right there and finish the operation.
Speaker 2 (09:56):
Which is wonderful because not only does it say moving
the patient, I mean as far as time surgeons.
Speaker 3 (10:02):
Are anesthesia and anesthesia.
Speaker 2 (10:04):
And so you don't want to keep people under anesthesia
as long. And that's they have one procedure, they're done,
they're asleep, and they wake up and everything is done.
That's wonderful and that state of the art, and that's
what you want, and I think that's fabulous. Now, let's
talk a little bit about why, you know, cardiovascular health
is so important, particularly in this area. You know, we're
(10:25):
in Midwest, we're in southern Ohio, the Appalachian region, and
my understanding is there's a lot of issues with hearts,
with heart attacks, strokes and problems like that.
Speaker 3 (10:44):
Well, you know, cardiovascular health is very important because the
number one killer is cardiac in this country, both sort
of men and women, and it's more than cancer, and
it's more than accidents. And another one in the top
five is of course death by stroke. A lot of
people you know die following a stroke. And the reason
(11:06):
why it's very important in this area is because number one,
a lot of people smoke in this area. That's very common.
The second thing is the counties. There's so many counties
the area is so widespread, and access to medical care
it is not easy when you have a rural area,
(11:28):
you know, a large proportions, so a lot of people
you know, do not have access to medical care directly.
And if you have a regional center like a DINA
at least that can cover a lot of these areas,
it'll be easier for people to you know, come and
seek medical care. So it's more difficult for them, of
(11:49):
course to go to Columbus, and many of them find
Columbus far away. Obviously, Chilicoth is going to be much
closer and there's no reason not to come here. And
have the medical care here. Almost everything can be done here.
I mean the things that come to mind that can
be done here would be things like transplant, and in
any case, transplant is done in select centers in the
(12:11):
whole country. So but if you have if you need
open heart surgery, including bypass surgery iotic valve procedures, which
are commonly done in most places, it's the same operation
that you get here or elsewhere. It makes no difference
where you are. At the same time, because of the
fact that you have so many counties to cover, you
have I think nine counties are covered by the health
(12:33):
system here and you know, three access critical care access hospitals,
it was difficult to transport patients. But I had recently
that Adena is going to have two ambulances that are
going to work in transferring patients from the critical care
critical access hospitals to the main hospital more efficiently, because
(12:57):
in the past, if they depended on a guin commercial
transportation and patients would wait a long time in one
area before coming to the main hospital. So that can
be solved also, and there's no reason not to bring
these patients quicker and work on them earlier.
Speaker 2 (13:17):
Which is fabulous, which they've just presented to us, letting
us know that they've established this and this is going
to be happening in the next few months or is it.
Speaker 4 (13:25):
Yeah, it's going to be this fall.
Speaker 2 (13:26):
This Also, they'll have their own ambulance system between the
outlying hospitals and here, so people will get here immediately,
so the cardiovascular surgeons whoever else they need to have
can be ready to go and they get right in
and there's no wait, so, which is great.
Speaker 1 (13:41):
That's huge life saving.
Speaker 2 (13:43):
Yeah.
Speaker 3 (13:43):
Wow. Potentially, it's mainly for whenever you have heart attacks.
Patients you know, can be having a heart attack at
the hospital that's you know, forty miles away, and time
is what's called heart muscle. The longer you wait, the
more heart must be goingly lose. So it's very important
(14:03):
to expedite the transfer because you want to get these
patients to the cat lab at Adena here in Chilicothe
and have this tent or angioplasty or whatever procedure needs
to be done done as quickly as possible. The goal
is always, always, you know, within less than ninety minutes,
and it can be achieved if the patient is transferred,
(14:25):
died away and worked upon in the main hospital.
Speaker 2 (14:30):
That's awesome, which is fabulous. So you had talked a
little bit about some of the things that are being done,
and you know, the people in our area, we have
a lot of smokers, we have a lot of overweight people.
You know, they just they don't take care of themselves.
And so if somebody wants to get you know, come in.
What are some of the things that you share as
far as the resources, some of the screenings that are done.
Speaker 3 (14:53):
There are quite a few things that can be done. There's,
of course, what's called a s stress. Stress test is
a common test that is done many times in situations
where one is not sure whether the problem is from
the heart or something else. So a stress test can
tell you which way to go. It's non invasive, in
(15:16):
other words, you don't have to put the wires and
catheters inside the heart. It's done by means of xtra
equipment and something you inject IV. That's one thing that
they can be done, and that can tell you whether
the patient needs cardiac characterization, a stent, or anything in
the future. That's obviously one of the very common tests
(15:39):
which are done. The other one is what you call
calcium scoring. There's a test where you can measure the
amount of calcium in the heart, which can give you
an indication of whether the vessels of the arteries which
feed the heart, which give blood to the heart, are
(15:59):
themselves narrowed or expected to be narrowed if the calcium
score is high. So if the calcium score is high,
then that's another indication that you should do the next
test and find out whether there's blockage in the heart
or there isn't. One of the more common things which
are done nowadays, also becoming very much used, is what's
(16:23):
called a cat sc angio of the heart. Just like
you do a cat scan to look at the lungs
see if there's a tumor in it or anything like this,
you can do a cat scan of the heart itself
and that can give you a picture of the circulation
of blood inside the heart. It can show you whether
there's this blockage in one area or narrowing in one area,
(16:44):
and based on that you can again go to the
next step. So these are kind of screening tests that
you can do. The screening test can lead you to
a more definitive test which can be done in the hospital.
Also many times during the same admission, you don't have
to come back.
Speaker 4 (17:01):
You stay in the hospital.
Speaker 3 (17:02):
You get the other test, which is usually a card
characterization that can lead either to extend a balloon ANGI
of blast you or even of not surgerty during the
same admission.
Speaker 2 (17:15):
That's fabulous. So yeah, I'm just so totally impressed because
I'm just sitting here listening to you and you're just
so relaxed talking about this, and I'm like, this is awesome,
you know, because of what you're doing. But I think
what I've been so impressed with is basically the quality
of the surgeons that Adina has brought in to deal
(17:37):
with this. These guys have done this for years and
at major institutions, just doctor Twell himself, but some of
the other surgeons that are here. And you know what
I always tell people, I said, you know what, you
need to look at the quality of these people. These
are fabulous surgeons and they've been at other wonderful places.
(17:59):
They've done this recedure over and over and over. And
if you want to put yourself and your family member
in good hands, you want to do so, you know,
be with somebody who's done this right. And these guys
have done it, and that's what's wonderful. And that's what
I think. I'm impressed with Adena bringing these kind of
people in because I was like, how did they get
(18:20):
them right? You know? And I think it's wonderful. I
think it's wonderful for the area. I think it's wonderful
for our surrounding communities. And I would have no reservations
coming here myself, absolutely not, because the quality of these
guys is impeccable. So I'm very very impressed, and I
just want to stress this with everybody. I mean, I
(18:42):
really am right.
Speaker 1 (18:42):
Well, that's what I'm thinking too, Doctor to Will, with
your background, your experience, you could go anywhere. So there
must have been something about Adina, like you said, you know,
the people and the technology that are both in place
there that that you would feel comfortable coming here. So
that makes us feel comfortable, like, wow, you know that
we talked about that this is available, are here till
a coffee? We don't have to give a Colombus to
Cincinnati or somewhere else. It's just amazing that this type
(19:05):
and this caliber of surgeons and this type of facility
is right here at our disposal. You know, a lot
of times some people don't even know about it or
else we take it for granted that you know, Adina
is on the cutting edge and this is this is
just amazing.
Speaker 3 (19:18):
One thing else I want to mention is the other
associated problems that you can have with heart disease and disease.
You know, this can cause stroke. Aneurysms are another one
also karroated problems created the occlusion or rest or narrowing
of the karateid arteries. Aneurysms are quite common and they
(19:41):
go hand in hand with all the other cardiac diseases.
They are again related to smoking, to high blood pressure.
All of these you know, are you know, a common
problem everywhere. Aneurysms can also be treated with stents and
that's another thing that can be done the hospital.
Speaker 4 (20:01):
Here.
Speaker 3 (20:01):
They can be aneurysms in the belly or it can
be in the chest. You can also have an operation
if you need it for an annually, depending on the situation.
The other one is karate its kartis in which are
the arteries that go in the neck that go to
the brain. Those arterists can have blockage just like the
(20:22):
blockage of the arteries of the heart. Again, they can't
be either stented. You can put the stent in them,
or you can have an actual operation done, depending on
the particular patient.
Speaker 2 (20:36):
So what I'm hearing is the fact that these guys
are so well trained. And what I really liked was
the fact that you had done so many mock trials
before you even started, which is amazing. You know, as
he said, there's no room for you know, error they
want to make sure that they've got everything done, that
they can do everything correctly the first time. And I
(20:59):
think that's fab So they've got the staff trained, everybody's trained,
You've got the surgeons who can do all of these procedures,
and you have a state of the art facility. I'm
just like, it's fantastic. And so the nice thing and
what the unbelievable thing is that it's here in Chilicathy,
and these guys have been brought in and they're here now,
(21:19):
and so I'm very very excited about it. You know,
Adina believes in you know, patient patients come first, and
you know, listening to you and your partners talk, you know,
and one of your partners mentioned to me, you know,
you would think these cardiovascular surgeons have egos, you know,
(21:40):
and they're not. They're down to earth, very very nice,
very easy to talk to, as you can tell the
radio with doctor Till, very easy to talk to, and
they will listen and they're there for you, and they're
there at all hours. Whatever you need. There's somebody you
know available to help you. And very very happy that
(22:01):
the families you know of our friends are the patients
that we take care of. I mean, I take care
of a lot of people in this town, and I'm
so happy that they don't have to go far for help,
which is wonderful. Why else am I missing? Doctor? Well,
there's so much with you guys, what you do, There's
so much.
Speaker 4 (22:22):
Yeah.
Speaker 3 (22:22):
We are in the process actually now of launching also
the Tavera program. The tablet program is the program where
you put valves through the growing to replace the let's say,
the aortic valve.
Speaker 4 (22:35):
In the heart.
Speaker 3 (22:36):
This again, this is the next step, and we should
be starting that hopefully within the next month or so.
We have a lot of patients, you know, who are
candidates for that, and these patients typically are much older.
Many of them have many medical problems such that they
cannot tolerate a procedure where you open the chest and
(22:57):
replace the valve in the aortic area. These people will
need something like a stent basically, just like you do
stents for the carotids or the arteries of the heart
or even aneurysms in the belly or chest. So what
you do in this particular case is you feed the valve.
(23:18):
The valve is crimped over a wire, okay, and you
put it through the groin through the main artery in
the groin. This is fed into the area of the
valve which is now not working well or very narrow
and all calcified and not functional. You feed that valve
in a crimped fashion into that spot and you place
(23:40):
the valve there and the device can be opened from
the outside. You open it so that it opens up
and takes the place of the other valve. Really, it
opens up just like a normal valve. It has three leaflets.
The leaflets open and close like a normal valve. And
you know, in one instant you can change a totally
(24:02):
diseased valve which is not doing the job, leaking and
too narrow, into a new value that you put in
which begins to function immediately. So patients, you know, have
immediate relief. Really, and usually it's a shortens of breath,
which is the biggest thing. They're kept typically overnight only,
or if they need another day, we give them another
(24:24):
day till they are comfortable going home and they have
a new valve without having to open the chest. That's
what's called the Tavern program, and we're working on that
at this time. We've had two marks actually already in
the past ten days, and we're hoping to have a
couple more meetings go over more details and that should
(24:48):
be relaunched very soon. This was done before at a
Dina also, but again it was halted for a short time,
and now we are ready to relaunch.
Speaker 2 (24:57):
It, which is wonderful. So yeah, you know, I don't
know if people really realize how how important this is
and how far advanced this is. You know, only a
few years ago they were just opening chests to do this,
and these people that is such a delicate surgery. Some
of these people wouldn't have survived with the open heart,
the open opening of the chest correct.
Speaker 3 (25:18):
But because of all the associated problems they have. Many
of them have very bad lungs. They have you know,
usually bad kidneys, a lot of other problems, a frail
and very old Many of them have not been able
to be active at all for a long time because
anytime they move a few steps they get short of breath.
Many of them modern oxygen already. So when you uh,
(25:41):
you know, replace the old valve by this new one,
it makes all the difference.
Speaker 2 (25:45):
So it gives them a new lease on life, which
is wonderful. So we thank you for that. That is
that's amazing to me. So, you know, medicine is changing rapidly,
and these guys are bringing medicine, you know, this new
updated medicine here, and it's wonderful. So let's just talk
about just a couple of other things. You know, we've
we've said over and over on this radio show that
(26:07):
you know, Adena has outstanding facilities. We talked about the
Orthopedic Center, which is state of the art also and
now we have this and now since with this, people
don't have to travel again. And that's what I think
is just fabulous. And is there anything else that we
want to talk about about? The cardiac program, the cardi thoracic.
Speaker 3 (26:28):
I think with the vascular surgeons, so of course are
an integral part of the whole thing. We have two
new vascular surgeons also, both of whom have started working,
and they've added a lot of new procedures you know,
that were not done before adena which are increasingly being
done elsewhere, including the stents to the karate artery, a
(26:53):
lot of procedures which are again non invasive, so to speak.
In other words, you don't have to cut for this thing.
You go, you put a wire to put a catheter,
and you do whatever you want inside the catheter. For example,
removing cloths from veins. People who have deep venus trombosis
(27:14):
and have clots in the veins which become you know,
a very large burden inside the vein, will cause problems
in the future.
Speaker 4 (27:22):
These can be suctioned out. Actually it's a.
Speaker 3 (27:27):
Procedure which is done through the vein itself. You just
put a wire, you put a device inside the vein
and you remove that cloth allow the vein to open
once again. If you don't do that, then in the
long run, these patients will have very swollen extremities, they
will have breakdown with the skin and have all sorts
of problems. That's one thing. The other thing is removing
(27:51):
cloths also from the arteries inside the lungs. If you
have clots inside the veins and lower extreme it is
and also in the pelvis. They can travel and go
into the lungs and they sit in the arteries of
the lung. If they are large enough, they can block
the main artery and essentially kill the patient. But if
(28:11):
they are a bit smaller, they can go to the branches.
And there are devices now which I watched one the
other day. One of the doctors did there, Doctor Hassan
suction out these clots from the right side of the lung,
from the artery to the right side of the lung.
It's a large amount of cloth, which makes all the
(28:32):
difference because the circulation to the lung improves instantly and
the long term effects of these clots sitting there for
a long time are negated.
Speaker 2 (28:42):
That's fabulous. Now they can breathe again. So I'm just
sitting and all I love it. I think it's fabulous.
I thank you so much for coming to the community,
for bringing this program, for restarting this for us. This
is something that we so need, and I really hope
that people understand how well trained these positions are, how
(29:05):
wonderful this facility is, and they don't want to do
anything they want to give the best care possible and
from what I'm seeing, they are and this is state
of the art, and I encourage everybody to find out
more and come in if you're interested. You know, you
can go through a Dina doctor to will in his
(29:27):
office is seven seventy nine four three six zero. You
can call and get in. Your family, your providers, your
PCPs can get you in easily. They will gladly take
care of you. Is there anything that you'd like to say?
Speaker 3 (29:43):
Appointments are very quick basically, you know, there's no wait.
Speaker 4 (29:47):
Most of the time.
Speaker 3 (29:49):
Whenever anybody calls, we get an appointment the following day
or most within two days.
Speaker 2 (29:53):
So yeah, they have to These are important things, so
they make sure they work hard to get you in.
So I love it. So I thank you so much much.
Thank you for being here today. Thank you very much
for having me so love it. Thank you, Christina. I
hope everybody hears this and understands what wonderful people want
wonderful physicians and serves.
Speaker 4 (30:11):
That we have.
Speaker 1 (30:12):
Yeah, amazing things being done here in Chillicofee and the
surrounding county is thanks to Ania. All right, this has
been Lady Parts with doctor Richard Villarreal. It airs the
third Monday of every month on Mix one oh six
point five f M and CHILICOFEE and it's brought to
you by a Dina Health System. You can find this
episode in past shows as well as a podcast on
iHeartRadio worldwide. Just open up the free iHeartRadio app and
(30:35):
do a search for Lady Parts with Doctor Richard Villarreal.
Mix one oh six ' five. Good morning, It's Christina Wolford.
It is time for Lady Parts with doctor Richard Villarreal
of Adina Obgyan. Good morning, doctor Villarreal. I'm doing great.
Speaker 2 (00:13):
How about you doing well?
Speaker 1 (00:15):
So it is time for another Lady Parts show. We
do this once a month thanks to Adina talking about
issues impacting women's health and sometimes men and women's health
together and we kind of have that. Today we have
a special guest in here today. Would you like to
introduce him?
Speaker 2 (00:28):
Sure? Today I have doctor to Will and he is
now the new medical director for the Cardiothoracic Surgery Center.
So I'm very excited about this. Doctor Twill has over
thirty years of experience that he brings to aDNA. I'm
very excited that he can't earn his medical degree from
the American University in Beirut. He completed his residency in
(00:52):
North Carolina Memorial Hospital in Chapel Hill. He did a
fellowship at the University Hospitals in Cleveland. He most recently
comes from Memorial Hospital and where he opened a heart
program in twenty twenty. So he has a lot of
experiences bringing to us and we're very excited about this.
So doctor, we're going to just talk a little bit.
Speaker 3 (01:12):
Start.
Speaker 2 (01:12):
Let's talk a little bit about you. What led you
to pursue a career in cardiothoracic surgery.
Speaker 4 (01:19):
Good morning.
Speaker 3 (01:20):
First of all, I think you're mostly influenced by the
physicians you work with during medical school training and later
on in fellowship. I was extremely impressed by the cardiothoracic
surgeons I worked with, both in Chapel Hill, North Carolina,
as well as at the University Hospitals in Cleveland, and
(01:41):
I thought, well, you know, at the beginning, I thought
I wasn't so sure whether it be in general surgery
or go to cardiothoracic surgery. But I thought I'd make
a difference more in cardiothoracic surgery.
Speaker 4 (01:53):
I'll take that.
Speaker 3 (01:54):
So I just chose that because of thinking that I
really will be able to have more in that particular specialty. Plus,
it's a very clean cut specialty. A lot of it
has to do with rhythm. It's I think mathematical in
many ways, and that really appeals to me.
Speaker 2 (02:14):
So wonderful. So what led you? So You've You're you're
bringing a lot of experience with DINA and that's you
presented to the physicians. You guys, you talked about what
you're doing, and we were so impressed and we thought
this would be wonderful sort of get this out to
the community about all the experience that is now at
a dina. And so what led you to come here.
Speaker 3 (02:35):
I had started a program in Marietta, actually in Ohio also,
and I saw this opportunity open up here because the
program was passed for a short time and everybody had
to make sure that the re launch would be very
well studied and examined and every step is properly taken.
(03:00):
So I thought, well, maybe there's a chance that I
can relaunch this program, and I helped relaunch it. So
I came here and basically it was the effort of
so many departments, of so many people, everybody working very hard,
and you know, meeting after meeting that went on and
on and going over every detail that really should be covered.
(03:25):
And at that point this was sent, you know, to
the High Department of Health and the program was relaunched, which.
Speaker 2 (03:34):
Is wonderful for Adena and all the people in this community.
So you mentioned the recruitment that you know, you had
to find the right additions to the team, both heart
and vascular leadership changes, facility and equipment enhancements I know happened.
So what does that mean for the patients.
Speaker 3 (03:54):
Well, first of all, I had checked about, you know,
the Adena health system here and and this was really
something I did with the cardiologist. Above all, the most
important thing is to have the proper people and then
the equipment.
Speaker 4 (04:11):
Uh.
Speaker 3 (04:11):
The cardiologists are a very good team here, definitely. They
all work very well with each other. They are everybody
is supportive and without their help and support, obviously you
can't have a cardiac program. You have to have cardiologists
to actually evaluate the patients and send them to surgery.
Speaker 4 (04:31):
So I checked about that before.
Speaker 3 (04:32):
I came, and and this was mainly the effort of
doctor Musa Musa, who is the uh the chief cardiologist here.
So at the same time I had found out more
from him about what the area was like, uh, the
need for cardiothoracic surgery, what the facility was like, and
(04:58):
you know, I found out that, you know, there are
three critical care hospitals that feed into the main hospital.
There was open heart before, definitely for many many years,
and everybody was quite experienced in that a lot of
the people who worked in open heart have been doing
it for many years.
Speaker 4 (05:19):
The equipment was certainly up to date.
Speaker 3 (05:22):
There is also what you call a hybrid room. Hybrid
room is a room which can be used both as
an operating room as well as a room where you
can do cardiology procedures in other words, cardiac characterizations, stents, interventions,
and also taver taver, which is a placement of aotic
(05:47):
valves through the groin into the area of the heart
where they should go. You know, the hybrid room is
a multimillion dollar room, which you know, which is which
everybody wants to have. And this is an up to
do you know, a state of the art room, and
definitely you know, there's.
Speaker 4 (06:05):
You know, we just used it today.
Speaker 3 (06:06):
Actually it's certainly a place that we'd like to work
at the same time, you know. Leading to relaunching the
open heart program, we had to go through various what
you call mock up.
Speaker 4 (06:24):
Trials where you go through an.
Speaker 3 (06:26):
Actual procedure without a patient and go through every step,
make sure every step is examined, and we did several
of those. Every time you do it, you find something
that you really have to make sure is a fool
proof and this is what we did, and this is
really the work of so many departments besides cardiology, the
(06:47):
operating room and sociologists. The profusion is to run the
heartline machine, which is essential for this procedure, the open
heart procedure, as well as the intent ensive care unit.
There's a brand new intensive care unit now and the
nurses are extremely experience They've done this for a long
(07:07):
time and the hearts that we have done so far,
you know, within the past two months, have been taken
care of very.
Speaker 4 (07:15):
Well by this group of nurses. So it's a lot of.
Speaker 3 (07:18):
Planning, a lot of evaluation, a lot of revision of things.
Still you get to the point where you can present
the product at the end. And the Department of Health
in Columbus has agreed to relaunching the program, which is
what we have done, and we have done several cases
so far and everything has been very well so far.
Speaker 2 (07:43):
Well that's exciting to hear. So, you know, I'm interested
a little bit exase I don't know much about the
cardiovascular health and so I was really interested in this
hybrid operating room and so how does that enhance care?
So I mean I know, it's a multimillion dollar area,
multimion dollars and this is the state of the art,
and everybody wants to have something like this. But why.
Speaker 3 (08:07):
A hybrid room is very useful because it can act
as like I said, an operating room as well as
a room where you can do cardiac procedures like stents
and in angioplasty and putting implants like what they put
for what you call aight refibrillation. You can put watchmen devices,
(08:28):
you can put defibrillators, you can put pacers.
Speaker 4 (08:33):
This is good because this room, first of all, is large.
Speaker 3 (08:38):
You can put all the equipment you need in one room.
It has anesthesia like an operating room. It also has
all the possible wires and stents that you can use
if you are doing a stent or a balloon for
a patient. And in those situations like sometimes invascular situations
(08:59):
where you are trying to do something and put a
stent and it doesn't work or the stent is not
the optimal thing and you want to convert and make
the procedure and operation, all you have to do is
keep the patient where it is. Anesthesia is right there,
and the procedure changes from a stent to an open
(09:20):
operation and you can complete the surgery there and without
moving the patient anywhere, and you minimize the amount of
anesthesia of course, and transfer the patient following that.
Speaker 4 (09:34):
To recovery or to the ICU.
Speaker 3 (09:36):
So it's a very convenient way of dealing with a
problem that can go either way. Or if you are
dealing with a bigger problem like you're doing, you know,
any kind of aneurism extent for an aneurism, if that
is going to change to an open procedure, you stay
right there and finish the operation.
Speaker 2 (09:56):
Which is wonderful because not only does it say moving
the patient, I mean as far as time surgeons.
Speaker 3 (10:02):
Are anesthesia and anesthesia.
Speaker 2 (10:04):
And so you don't want to keep people under anesthesia
as long. And that's they have one procedure, they're done,
they're asleep, and they wake up and everything is done.
That's wonderful and that state of the art, and that's
what you want, and I think that's fabulous. Now, let's
talk a little bit about why, you know, cardiovascular health
is so important, particularly in this area. You know, we're
(10:25):
in Midwest, we're in southern Ohio, the Appalachian region, and
my understanding is there's a lot of issues with hearts,
with heart attacks, strokes and problems like that.
Speaker 3 (10:44):
Well, you know, cardiovascular health is very important because the
number one killer is cardiac in this country, both sort
of men and women, and it's more than cancer, and
it's more than accidents. And another one in the top
five is of course death by stroke. A lot of
people you know die following a stroke. And the reason
(11:06):
why it's very important in this area is because number one,
a lot of people smoke in this area. That's very common.
The second thing is the counties. There's so many counties
the area is so widespread, and access to medical care
it is not easy when you have a rural area,
(11:28):
you know, a large proportions, so a lot of people
you know, do not have access to medical care directly.
And if you have a regional center like a DINA
at least that can cover a lot of these areas,
it'll be easier for people to you know, come and
seek medical care. So it's more difficult for them, of
(11:49):
course to go to Columbus, and many of them find
Columbus far away. Obviously, Chilicoth is going to be much
closer and there's no reason not to come here. And
have the medical care here. Almost everything can be done here.
I mean the things that come to mind that can
be done here would be things like transplant, and in
any case, transplant is done in select centers in the
(12:11):
whole country. So but if you have if you need
open heart surgery, including bypass surgery iotic valve procedures, which
are commonly done in most places, it's the same operation
that you get here or elsewhere. It makes no difference
where you are. At the same time, because of the
fact that you have so many counties to cover, you
have I think nine counties are covered by the health
(12:33):
system here and you know, three access critical care access hospitals,
it was difficult to transport patients. But I had recently
that Adena is going to have two ambulances that are
going to work in transferring patients from the critical care
critical access hospitals to the main hospital more efficiently, because
(12:57):
in the past, if they depended on a guin commercial
transportation and patients would wait a long time in one
area before coming to the main hospital. So that can
be solved also, and there's no reason not to bring
these patients quicker and work on them earlier.
Speaker 2 (13:17):
Which is fabulous, which they've just presented to us, letting
us know that they've established this and this is going
to be happening in the next few months or is it.
Speaker 4 (13:25):
Yeah, it's going to be this fall.
Speaker 2 (13:26):
This Also, they'll have their own ambulance system between the
outlying hospitals and here, so people will get here immediately,
so the cardiovascular surgeons whoever else they need to have
can be ready to go and they get right in
and there's no wait, so, which is great.
Speaker 1 (13:41):
That's huge life saving.
Speaker 2 (13:43):
Yeah.
Speaker 3 (13:43):
Wow. Potentially, it's mainly for whenever you have heart attacks.
Patients you know, can be having a heart attack at
the hospital that's you know, forty miles away, and time
is what's called heart muscle. The longer you wait, the
more heart must be goingly lose. So it's very important
(14:03):
to expedite the transfer because you want to get these
patients to the cat lab at Adena here in Chilicothe
and have this tent or angioplasty or whatever procedure needs
to be done done as quickly as possible. The goal
is always, always, you know, within less than ninety minutes,
and it can be achieved if the patient is transferred,
(14:25):
died away and worked upon in the main hospital.
Speaker 2 (14:30):
That's awesome, which is fabulous. So you had talked a
little bit about some of the things that are being done,
and you know, the people in our area, we have
a lot of smokers, we have a lot of overweight people.
You know, they just they don't take care of themselves.
And so if somebody wants to get you know, come in.
What are some of the things that you share as
far as the resources, some of the screenings that are done.
Speaker 3 (14:53):
There are quite a few things that can be done. There's,
of course, what's called a s stress. Stress test is
a common test that is done many times in situations
where one is not sure whether the problem is from
the heart or something else. So a stress test can
tell you which way to go. It's non invasive, in
(15:16):
other words, you don't have to put the wires and
catheters inside the heart. It's done by means of xtra
equipment and something you inject IV. That's one thing that
they can be done, and that can tell you whether
the patient needs cardiac characterization, a stent, or anything in
the future. That's obviously one of the very common tests
(15:39):
which are done. The other one is what you call
calcium scoring. There's a test where you can measure the
amount of calcium in the heart, which can give you
an indication of whether the vessels of the arteries which
feed the heart, which give blood to the heart, are
(15:59):
themselves narrowed or expected to be narrowed if the calcium
score is high. So if the calcium score is high,
then that's another indication that you should do the next
test and find out whether there's blockage in the heart
or there isn't. One of the more common things which
are done nowadays, also becoming very much used, is what's
(16:23):
called a cat sc angio of the heart. Just like
you do a cat scan to look at the lungs
see if there's a tumor in it or anything like this,
you can do a cat scan of the heart itself
and that can give you a picture of the circulation
of blood inside the heart. It can show you whether
there's this blockage in one area or narrowing in one area,
(16:44):
and based on that you can again go to the
next step. So these are kind of screening tests that
you can do. The screening test can lead you to
a more definitive test which can be done in the hospital.
Also many times during the same admission, you don't have
to come back.
Speaker 4 (17:01):
You stay in the hospital.
Speaker 3 (17:02):
You get the other test, which is usually a card
characterization that can lead either to extend a balloon ANGI
of blast you or even of not surgerty during the
same admission.
Speaker 2 (17:15):
That's fabulous. So yeah, I'm just so totally impressed because
I'm just sitting here listening to you and you're just
so relaxed talking about this, and I'm like, this is awesome,
you know, because of what you're doing. But I think
what I've been so impressed with is basically the quality
of the surgeons that Adina has brought in to deal
(17:37):
with this. These guys have done this for years and
at major institutions, just doctor Twell himself, but some of
the other surgeons that are here. And you know what
I always tell people, I said, you know what, you
need to look at the quality of these people. These
are fabulous surgeons and they've been at other wonderful places.
(17:59):
They've done this recedure over and over and over. And
if you want to put yourself and your family member
in good hands, you want to do so, you know,
be with somebody who's done this right. And these guys
have done it, and that's what's wonderful. And that's what
I think. I'm impressed with Adena bringing these kind of
people in because I was like, how did they get
(18:20):
them right? You know? And I think it's wonderful. I
think it's wonderful for the area. I think it's wonderful
for our surrounding communities. And I would have no reservations
coming here myself, absolutely not, because the quality of these
guys is impeccable. So I'm very very impressed, and I
just want to stress this with everybody. I mean, I
(18:42):
really am right.
Speaker 1 (18:42):
Well, that's what I'm thinking too, Doctor to Will, with
your background, your experience, you could go anywhere. So there
must have been something about Adina, like you said, you know,
the people and the technology that are both in place
there that that you would feel comfortable coming here. So
that makes us feel comfortable, like, wow, you know that
we talked about that this is available, are here till
a coffee? We don't have to give a Colombus to
Cincinnati or somewhere else. It's just amazing that this type
(19:05):
and this caliber of surgeons and this type of facility
is right here at our disposal. You know, a lot
of times some people don't even know about it or
else we take it for granted that you know, Adina
is on the cutting edge and this is this is
just amazing.
Speaker 3 (19:18):
One thing else I want to mention is the other
associated problems that you can have with heart disease and disease.
You know, this can cause stroke. Aneurysms are another one
also karroated problems created the occlusion or rest or narrowing
of the karateid arteries. Aneurysms are quite common and they
(19:41):
go hand in hand with all the other cardiac diseases.
They are again related to smoking, to high blood pressure.
All of these you know, are you know, a common
problem everywhere. Aneurysms can also be treated with stents and
that's another thing that can be done the hospital.
Speaker 4 (20:01):
Here.
Speaker 3 (20:01):
They can be aneurysms in the belly or it can
be in the chest. You can also have an operation
if you need it for an annually, depending on the situation.
The other one is karate its kartis in which are
the arteries that go in the neck that go to
the brain. Those arterists can have blockage just like the
(20:22):
blockage of the arteries of the heart. Again, they can't
be either stented. You can put the stent in them,
or you can have an actual operation done, depending on
the particular patient.
Speaker 2 (20:36):
So what I'm hearing is the fact that these guys
are so well trained. And what I really liked was
the fact that you had done so many mock trials
before you even started, which is amazing. You know, as
he said, there's no room for you know, error they
want to make sure that they've got everything done, that
they can do everything correctly the first time. And I
(20:59):
think that's fab So they've got the staff trained, everybody's trained,
You've got the surgeons who can do all of these procedures,
and you have a state of the art facility. I'm
just like, it's fantastic. And so the nice thing and
what the unbelievable thing is that it's here in Chilicathy,
and these guys have been brought in and they're here now,
(21:19):
and so I'm very very excited about it. You know,
Adina believes in you know, patient patients come first, and
you know, listening to you and your partners talk, you know,
and one of your partners mentioned to me, you know,
you would think these cardiovascular surgeons have egos, you know,
(21:40):
and they're not. They're down to earth, very very nice,
very easy to talk to, as you can tell the
radio with doctor Till, very easy to talk to, and
they will listen and they're there for you, and they're
there at all hours. Whatever you need. There's somebody you
know available to help you. And very very happy that
(22:01):
the families you know of our friends are the patients
that we take care of. I mean, I take care
of a lot of people in this town, and I'm
so happy that they don't have to go far for help,
which is wonderful. Why else am I missing? Doctor? Well,
there's so much with you guys, what you do, There's
so much.
Speaker 4 (22:22):
Yeah.
Speaker 3 (22:22):
We are in the process actually now of launching also
the Tavera program. The tablet program is the program where
you put valves through the growing to replace the let's say,
the aortic valve.
Speaker 4 (22:35):
In the heart.
Speaker 3 (22:36):
This again, this is the next step, and we should
be starting that hopefully within the next month or so.
We have a lot of patients, you know, who are
candidates for that, and these patients typically are much older.
Many of them have many medical problems such that they
cannot tolerate a procedure where you open the chest and
(22:57):
replace the valve in the aortic area. These people will
need something like a stent basically, just like you do
stents for the carotids or the arteries of the heart
or even aneurysms in the belly or chest. So what
you do in this particular case is you feed the valve.
(23:18):
The valve is crimped over a wire, okay, and you
put it through the groin through the main artery in
the groin. This is fed into the area of the
valve which is now not working well or very narrow
and all calcified and not functional. You feed that valve
in a crimped fashion into that spot and you place
(23:40):
the valve there and the device can be opened from
the outside. You open it so that it opens up
and takes the place of the other valve. Really, it
opens up just like a normal valve. It has three leaflets.
The leaflets open and close like a normal valve. And
you know, in one instant you can change a totally
(24:02):
diseased valve which is not doing the job, leaking and
too narrow, into a new value that you put in
which begins to function immediately. So patients, you know, have
immediate relief. Really, and usually it's a shortens of breath,
which is the biggest thing. They're kept typically overnight only,
or if they need another day, we give them another
(24:24):
day till they are comfortable going home and they have
a new valve without having to open the chest. That's
what's called the Tavern program, and we're working on that
at this time. We've had two marks actually already in
the past ten days, and we're hoping to have a
couple more meetings go over more details and that should
(24:48):
be relaunched very soon. This was done before at a
Dina also, but again it was halted for a short time,
and now we are ready to relaunch.
Speaker 2 (24:57):
It, which is wonderful. So yeah, you know, I don't
know if people really realize how how important this is
and how far advanced this is. You know, only a
few years ago they were just opening chests to do this,
and these people that is such a delicate surgery. Some
of these people wouldn't have survived with the open heart,
the open opening of the chest correct.
Speaker 3 (25:18):
But because of all the associated problems they have. Many
of them have very bad lungs. They have you know,
usually bad kidneys, a lot of other problems, a frail
and very old Many of them have not been able
to be active at all for a long time because
anytime they move a few steps they get short of breath.
Many of them modern oxygen already. So when you uh,
(25:41):
you know, replace the old valve by this new one,
it makes all the difference.
Speaker 2 (25:45):
So it gives them a new lease on life, which
is wonderful. So we thank you for that. That is
that's amazing to me. So, you know, medicine is changing rapidly,
and these guys are bringing medicine, you know, this new
updated medicine here, and it's wonderful. So let's just talk
about just a couple of other things. You know, we've
we've said over and over on this radio show that
(26:07):
you know, Adena has outstanding facilities. We talked about the
Orthopedic Center, which is state of the art also and
now we have this and now since with this, people
don't have to travel again. And that's what I think
is just fabulous. And is there anything else that we
want to talk about about? The cardiac program, the cardi thoracic.
Speaker 3 (26:28):
I think with the vascular surgeons, so of course are
an integral part of the whole thing. We have two
new vascular surgeons also, both of whom have started working,
and they've added a lot of new procedures you know,
that were not done before adena which are increasingly being
done elsewhere, including the stents to the karate artery, a
(26:53):
lot of procedures which are again non invasive, so to speak.
In other words, you don't have to cut for this thing.
You go, you put a wire to put a catheter,
and you do whatever you want inside the catheter. For example,
removing cloths from veins. People who have deep venus trombosis
(27:14):
and have clots in the veins which become you know,
a very large burden inside the vein, will cause problems
in the future.
Speaker 4 (27:22):
These can be suctioned out. Actually it's a.
Speaker 3 (27:27):
Procedure which is done through the vein itself. You just
put a wire, you put a device inside the vein
and you remove that cloth allow the vein to open
once again. If you don't do that, then in the
long run, these patients will have very swollen extremities, they
will have breakdown with the skin and have all sorts
of problems. That's one thing. The other thing is removing
(27:51):
cloths also from the arteries inside the lungs. If you
have clots inside the veins and lower extreme it is
and also in the pelvis. They can travel and go
into the lungs and they sit in the arteries of
the lung. If they are large enough, they can block
the main artery and essentially kill the patient. But if
(28:11):
they are a bit smaller, they can go to the branches.
And there are devices now which I watched one the
other day. One of the doctors did there, Doctor Hassan
suction out these clots from the right side of the lung,
from the artery to the right side of the lung.
It's a large amount of cloth, which makes all the
(28:32):
difference because the circulation to the lung improves instantly and
the long term effects of these clots sitting there for
a long time are negated.
Speaker 2 (28:42):
That's fabulous. Now they can breathe again. So I'm just
sitting and all I love it. I think it's fabulous.
I thank you so much for coming to the community,
for bringing this program, for restarting this for us. This
is something that we so need, and I really hope
that people understand how well trained these positions are, how
(29:05):
wonderful this facility is, and they don't want to do
anything they want to give the best care possible and
from what I'm seeing, they are and this is state
of the art, and I encourage everybody to find out
more and come in if you're interested. You know, you
can go through a Dina doctor to will in his
(29:27):
office is seven seventy nine four three six zero. You
can call and get in. Your family, your providers, your
PCPs can get you in easily. They will gladly take
care of you. Is there anything that you'd like to say?
Speaker 3 (29:43):
Appointments are very quick basically, you know, there's no wait.
Speaker 4 (29:47):
Most of the time.
Speaker 3 (29:49):
Whenever anybody calls, we get an appointment the following day
or most within two days.
Speaker 2 (29:53):
So yeah, they have to These are important things, so
they make sure they work hard to get you in.
So I love it. So I thank you so much much.
Thank you for being here today. Thank you very much
for having me so love it. Thank you, Christina. I
hope everybody hears this and understands what wonderful people want
wonderful physicians and serves.
Speaker 4 (30:11):
That we have.
Speaker 1 (30:12):
Yeah, amazing things being done here in Chillicofee and the
surrounding county is thanks to Ania. All right, this has
been Lady Parts with doctor Richard Villarreal. It airs the
third Monday of every month on Mix one oh six
point five f M and CHILICOFEE and it's brought to
you by a Dina Health System. You can find this
episode in past shows as well as a podcast on
iHeartRadio worldwide. Just open up the free iHeartRadio app and
(30:35):
do a search for Lady Parts with Doctor Richard Villarreal.
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