NMMC Cath Lab Featured for Quality Improvement in National Digest
NMMC Cardiac Catheterization Laboratory was featured in Cath Lab Digest’s Quality Improvement Spotlight Article for September.
TUPELO, Miss.—North Mississippi Medical Center was featured in Cath Lab Digest’s September issue for successfully using new technology to reduce the amount of X-ray dye used in cardiac catheterization and percutaneous coronary intervention procedures.
Patients with normal kidney function can usually tolerate the X-ray dye because their kidneys can flush it through their system quickly. However, patients with compromised kidney function (such as those with diabetes or congestive heart failure, and older patients) are less able to tolerate dye usage because the dye spends more time in their kidneys. Around 30% of all patients with bad kidney function who undergo these procedures are at risk of having an Acute Kidney Injury (AKI).
“Because of Mississippi’s high obesity rate and its correlation with diabetes, we see a higher number of patients in whom we must worry about their kidneys as a result,” said interventional cardiologist Barry Bertolet, M.D.
NMMC uses the DyeVert System, new technology that allows adequate imaging of the coronary vessels while at the same time reducing contrast dye use by 40-50%. “The amount of contrast delivered to the patient probably plays the biggest role in the outcome of these patient with compromised kidney function,” Dr. Bertolet said.
The first step is to identify at-risk patients. Like most facilities, NMMC was focusing on patients who had previously been diagnosed with chronic kidney disease. Now, kidney function is calculated on all patients before their procedure. If a patient meets a certain threshold, the DyeVert system is used automatically.
“I get the adequate image of the heart, but the patient receives much less contrast,” Dr. Bertolet said. “So far, these at-risk patients for renal failure or those who would have required dialysis immediately after the cath to pull off the contrast have been doing extraordinarily well since we began this protocol.”
NMMC has 18 cardiologists on staff who perform around 3,500 heart caths and 1,400 percutaneous coronary interventions each year. NMMC has four cath labs, a hybrid operating room and three cardiac electrophysiology labs.