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Kitsap Cardiology provides top services close to home

Impella DeviceSeveral years ago, it was common for Kitsap residents to travel to Seattle for heart-related care. These days, patients of Kitsap Cardiology Consultants can get most of their procedures done locally — thanks to the full range of services at the practice and state-of-the-art equipment at Harrison Medical Center.

“There are only a few, highly specialized things that can’t be done here,” said Dr. David Tinker, co-founder of Kitsap Cardiology Consultants with Dr. Arthur Lee.

Lee and Tinker were the first cardiologists in Kitsap County. They opened separate practices in Bremerton in 1982 and a year later merged their offices. Since then, Kitsap Cardiology has grown steadily, outgrowing the original 4,000-square-foot facility they built. Today, the practice has nine cardiologists and three internal medicine physicians on board, and Tinker says they’re close to outgrowing the 10,000-square-foot space where they moved five or six years ago. The group specializes in all cardiology aspects, vascular services and electrophysiology, among others, treating everything from congestive heart failures and heart attacks to cardiac arrhythmias.

The independent Bremerton practice, which is owned by five doctors, serves patients at five other sites as far as Forks on the Olympic Peninsula. Cardiologists travel to Port Orchard, Poulsbo, Sequim, Port Townsend and Forks on a regular schedule.

Forks patients can also be seen by a cardiologist in between visits through telemedicine — via a remote teleconference in which the physician can communicate from Bremerton with the Forks patient using a digital camera and computer screen. The telemedicine service is a collaboration between Kitsap Cardiology and Clallam County Hospital District 1, which obtained a matching USDA grant for telecommunications equipment. The technology can show EKG streaming in real-time, and has a stethoscope attachment so a doctor or nurse practitioner can listen to the patient’s heartbeat, as well as a handheld camera that allows the cardiologist to remotely examine the patient.

Lee says cardiology is one of the most evolving fields in medicine. “When I first came to town, there was one in seven chances you would make it home (from the hospital) after a heart attack,” he said. “Now chances are 90 percent that you’ll go home.”

The evolution of technology and medications has contributed to the growth of interventional cardiology. Lee said in his early days in practice, the concept of stopping a heart attack was new and a cardiologist “knew everything there was to know.” Today, there are many subspecialties, and the field has been very successful in improving the patients’ survival rates as well as quality of life.

“Statistics show throughout the country that fewer people die from heart disease and heart attack,” Tinker said. “Part of that is because we can treat patients better and we have better-trained paramedics, but people are also smoking less. If we could get people to stop smoking, eat right and exercise, it would cut the workload hugely.”

Just as cardiology has evolved, Kitsap Cardiology Consultants has grown to better serve patients locally. “Over the years, we’ve tried to keep pace with the community needs — adding staff if we’re understaffed, adding services as needed and recruiting new physicians,” he said.

State-of-the-art Impella device

One of the most recent technologies adopted by Kitsap Cardiology is a breakthrough, minimally invasive device called Impella. Harrison Medical Center is one of only seven hospitals in Washington using the device, and as of Aug. 31, about 25 procedures using Impella have been performed statewide (and more than 600 worldwide).

Lee said as stenting and other technology got better, interventional cardiologists are able to treat sicker patients. But for some patients, there is a risk the artery would close while doctors are working on it, which could be lethal. With Impella, that risk is minimized.

“It helps unload the blood from the heart into the rest of the body — like a mini-bypass machine,” said Dr. Satyavardhan Pulukurthy, one of two Kitsap Cardiology interventional cardiologists performing the procedure, and a 2009 Kitsap Peninsula Business Journal 40 Under 40 honoree.

Impella is inserted into the left ventricle during a standard catherization procedure through the femoral artery. The device is about 1/8th of an inch thick and has a motor that sucks the blood and delivers it to the aorta. It doesn’t require surgery or general anesthesia.

The device allows for high-risk stenting procedures to be performed at Harrison. “This is for people who can’t have a bypass (surgery) because their heart is too weak or they have kidney disease,” said Pulukurthy, who has five national board certifications.

He said so far, Impella has been used on two patients at Harrison and both are doing well. The procedures lasted six to seven hours, and both patients avoided heart attacks, which would have happened without the Impella.

The Impella could also be used for patients waiting for a heart transplant to serve as a “bridge to transplant” while they’re en route to the transplant center, and also serve as a temporary heart during an acute heart attack or cardiac arrest.

“We used to send patients to Seattle to University of Washington or Swedish, and now because of availability of technology we can do those high-risk procedures here,” Pulukurthy said. “This state-of-the-art technology is up and coming, and in the future more of these devices will be commonly used.”

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