A History of Outstanding Cardiovascular Care

WakeMed has long been a leader in cardiovascular care. Below, Dr. Helton recalls some of this rich history.

50+ Years of Heart Surgery

WakeMed began its esteemed tradition of providing high-quality and highly advanced heart care during WakeMed’s first decade. The first open-heart surgery was performed at WakeMed (then known as Wake Memorial) on March 2, 1968, by Raymond Kornegay, MD, and James Davis, MD – making WakeMed the second community hospital in the state to perform open heart surgeries.

The procedure took about seven hours, and the patient spent 10 days in the hospital before being discharged. Over the next decade, Dr. Kornegay and Dr. Davis performed almost 100 cardiac and vascular cases at WakeMed.

reddy-davis-helton — From left to right: Dr. Amarendra Reddy, Dr. Jim Davis and Dr. Charles Helton

WakeMed Heart Center Also Celebrates March 2

The WakeMed Heart Center opened its doors to patients on March 2, 1998. WakeMed’s original Heart Center was located in what is now the Medical Office Building on WakeMed Raleigh Campus. The state-of-the-art facility brought together all testing and diagnostic services for heart patients, including cardiac cath labs and cardiovascular testing.

More than twenty years later, patients and families continue to appreciate exceptional care and conveniences found in the WakeMed Heart Center – including dedicated parking and access to the Heart Center Inn.

Recently, we spoke with WakeMed Heart & Vascular surgeon, Charlie Helton, MD. Dr. Helton was a key player in the early days of WakeMed’s cardiovascular program, and he also played an integral role in bringing the WakeMed Heart Center to life.

Below, Dr. Helton shares some of his recollections of the evolution of cardiovascular care at WakeMed.

A New Career at WakeMed

Some 40+ years ago, I was a new faculty member and attending surgeon at the University of Minnesota Hospital. Our chief cardiovascular resident was ill and unable to take in-house night call for the service, so that responsibility came back to me as the newest cardiovascular staff member.

My first night back, I got a call from Dr. Jim Davis. He was looking for the Chief Resident in cardiovascular surgery at the Mayo Clinic. I told him that he had called the University of Minnesota Hospital in Minneapolis and that the Mayo Clinic was in Rochester, Minnesota – seventy miles away.

When I offered to help him to see if he needed to refer a patient, he told me he was calling the Mayo Clinic cardiovascular resident to make him aware of a job opportunity in Raleigh. Two weeks later (when it was -20 degrees in Minneapolis), I was interviewing for a job in Raleigh.

The Early Days of Cardiovascular Care at WakeMed

When I came here in 1977/78, Charlotte and WakeMed (then known as Wake Memorial Hospital) were the only two hospitals in the state other than Duke and Chapel Hill that had any kind of cardiac surgery program.

The model of a combined cardiology and cardiac surgery service in a community hospital was a new concept in 1978. The technology was new, expensive, and to some degree unproven. The consensus at the time was that such an endeavor was best suited for university programs or large clinics, such as the Mayo or Cleveland Clinic.

When WakeMed was built, it was viewed as the county general hospital. There wasn’t a specific area of expertise; it was just a general hospital that would transfer difficult cases to UNC or Duke.

Bill Andrews, the president of WakeMed at the time, – and the board leaders, saw the need and the potential to develop not just a county general hospital but a hospital that offered high level specialty care for all citizens of Raleigh and the surrounding counties.

Bill Andrews and the hospital board envisioned a hospital that could provide comprehensive care with limited need to transfer patients to other centers for specialty care.

Understanding a Need for Treating Heart Disease

The Board came to understand that the diagnosis and treatment of cardiovascular disease at the time was an unmet need in our community.

They also realized that if the hospital could develop this specialty as a service line, it would have a high probability of ensuring a much needed and stable revenue stream for the hospital. They turned to Drs. Kornegay and Davis who had done some cardiac surgery at WakeMed in the early 1970’s.

WakeMed initially recruited Dr. Amarendra (Amar) Reddy in 1976. Dr. Reddy was a fellowship trained cardiologist from the Cleveland Clinic who did the first heart catheterization procedures at WakeMed. These procedures were originally done in the radiology department where the images were produced on 16mm film and projected onto a screen. Two years later, Dr. Tift Mann came to Raleigh and joined WakeMed as a cardiologist. He and Dr. Reddy established the first heart catheterization team in Raleigh.

A few years later, Drs. Charlie Mangano, Ray Cheely, Virgil Wynia and Michael Zellinger joined WakeMed and developed the noninvasive cardiology component of the cardiovascular service line.

Initial Responsibilities at WakeMed

When I first came to WakeMed, they wanted me to re-start the cardiac surgery service that had been discontinued in the mid 1970’s and build a sustainable program with the cardiologists who were here. This involved developing a team in the operating room. In addition, I met with the Intensive Care Unit (ICU) nursing staff.

Various members of the WakeMed team traveled to Minneapolis on several occasions to observe the University of Minnesota team. We developed care plans for the ICU and nursing staff as well as safety checklists for the operating room staff.

For the first three open heart cases, the complete team from the University of Minnesota came to Raleigh to help us get started. We did 100 cases in the first year. Since I was essentially in solo practice my first year and a half at WakeMed, I stayed in the hospital for the first couple of days after surgery for the first 50-60 cases until everyone was comfortable with their role.

The Evolution of Cardiovascular Care

This is my 54th year as a heart surgeon. You’d have to have gone through it all to realize the history of what it took to do heart surgery. Certainly in the ‘50s and ‘60s when I was in medical school, it was a lot of work to get one case done. There’s no way a hospital could do 1,000 cases in those days because they didn’t have enough man power, but a lot of people needed it.

Cardiac surgery got its real start in the 1950’s with the advent of the heart & lung machine. This machine allowed surgeons to operate inside of the heart while maintaining circulation to the rest of the body.

In the ’50’s and ’60’s, the technology was not very good, and there were many surgical complications, which were related to the heart & lung machine itself. Today, the technology of cardiopulmonary bypass is much more advanced, and complications related to cardiopulmonary bypass are rare. This has allowed complicated intracardiac operations to be completed safely.

The technical progress in my 50+ years of being involved in heart surgery has been remarkable.

In 1967, when I first got started in heart surgery, no one in the surgical community envisioned the progress that cardiology has made in the last fifty years. All of this progress is evident at WakeMed daily in the services we offer to our patients.

Today, it’s state-of-the-art. Nationwide, everybody has roughly the same standards. Along the same time, cardiologists have gotten much better at what they do. They now have the medicine to treat heart disease or to prevent it from happening in the first place.

Forming the Heart Center

The idea for creating the Heart Center came about because the heart catheterization lab was shared with radiology in their department. As the cardiac volume grew, the space, equipment, and sharing arrangements didn’t meet the needs of either the radiologists or cardiologists. Once the administration was convinced that the cardiology practices were on a sustainable growth curve, they were enthusiastic supporters of a dedicated heart center.

So, the concept came – well, let’s start to build a heart center. Then came the question of “What kind of heart center do you want?”

Do we want catheterization labs and a post catheterization recovery area?
Do we want a full service heart center with non-invasive testing and peripheral vascular capability?
Do we want patient rooms in the heart center?
Since many of our patients came from out of town, do we want to provide lodging for the patient’s family?

That concept led to the consideration of a hotel on the top of the heart center for families of out of town patients.

The next challenge was to develop the staff and the care plans for the anticipated volume increase. Betsy Gaskins McClaine was given the responsibility for staffing the new heart center and managing the supply chain for efficiency.

What about the Heart Center Inn?

I initially brought up the idea of the Heart Center Inn based on my experience at Abbott Northwestern Hospital in Minneapolis when a relative of mine was hospitalized there. They had closed an on-campus nursing school dorm and allowed it to be used as an overnight stay facility for use with out-of-town families. The rooms were like college dorm rooms of the 1960’s.

A group of us visited the hospital, liked the concept and agreed to ask WakeMed to add slightly larger rooms that could later be converted to hospital beds for specialty care if the concept of the Heart Center Inn didn’t prove viable.

A Commitment to Serving the Cardiovascular Needs of the Community

Our role is to provide the best we can for the total health of the community.

The big reward to me is the contribution to caring for the people in our community. We were the first guys in this community to offer that level of [cardiovascular] care. We were the innovators.

The fact that we were able to offer a high level of cardiovascular care to the community was very rewarding and still is. [WakeMed] could’ve picked anything, but they picked heart surgery, and it has panned out. Also, the leadership of the hospital over the years has been quite good, and the leadership that we have now is unbelievably good.

Everybody is a member of the team – then and now – and has a contribution to make. It’s not just the doctors; it’s all about the nurses, technologists and support staff who work with us. We can’t do anything without them.

It took all of us getting together and saying, “We’ve got to do this.” The net effect was that we built a hospital and heart center for our community.