Looking inside the heart

Article taken from The Bay City Times
Monday, February 12, 2007

By Amy Jo Johnson

    New computer software at Bay Regional Medical Center gave heart doctors beautiful 3-D images of Norma J. Stempien's pumping heart on Friday.
    The images were part of the first cardiac magnetic resonance imaging to take place in the Tri-Cities.  The procedure is non-invasive and allows doctors to see the heart with more detail than ever before.
    "You can actually see the heart in motion," said Kurt Miller, director of marketing and public relations for the hospital.
    Using a magnetic resonance imaging (MRI) unit costing about $1.6 million and new heart software totaling $55,000, doctors were able to see exactly where blood is leaking from Stempien's heart - and detail exactly how much.
    Dr. Susan M. Sallach, an advanced imaging cardiologist with the Michigan Cardiovascular Institute in Saginaw, and Dr. Stephen A. Messana, a nuclear radiologist at Bay Regional Medical Center, both said the new imaging has a number of benefits.
    It not only allows physicians to evaluate the heart structure and tissue; it also can provide the amount in milliliters of blood flowing through heart valves during each heart beat, they said.
    Sallach said the difference between an ultrasound and cardiac MRI is like looking with a flashlight or turning the lights on in a room.
    "You see a lot more," she said.  "You can answer questions you could never answer before.  It's just incredible technology."
    Messana said the imaging shows the function of the muscle as it accepts blood in and pumps blood out, whether muscle tissue is normal or abnormal and how blood is flowing.
    The images will give doctors insight into leaking heart valves and heart failure - and the best forms of treatment.  They will be able to tell if a patient will benefit from heart surgery or not, Messana said.
    "You can tell whether that heart muscle is viable," Sallach said.
    Cardiac MRI doesn't take the place of other tests like echocardiography, nuclear cardiology and CT scan, Sallach said.  But a cardiac MRI might be ordered to give doctors a better, clearer picture of what's going on with a patient's heart.
    For example, cardiac MRI might be ordered if doctors want to get a definitive look at what's going on with the right side of the heart because of technical limitations of other imaging.
    "This is now the gold standard for evaluating the right side of the heart," Sallach said.
    The new heart imaging is exciting stuff, she said.
    "We get really beautiful pictures," Sallach said.  "We've never been able to look at the heart this way."
    For Stempien, Friday's images showed an enlarged aorta and blood leaking back into the left ventricle.  Sallach said she, Messana and Stempien's cardiologist, Dr. Dan T. Lee, will review the results of Friday's imaging and make recommendations based on that.
    Stempien said she's just hoping she can avoid open heart surgery.
    The 76-year-old Gladwin resident said the test was relatively easy.  The only tough part was that she's been experiencing shortness of breath and she had to hold her breath for a few seconds during the test.
    "At the end it was (hard) because it was a longer period to hold my breath," she said.
    Stempien, who listened to Hank Williams Jr. music during the procedure, said it was pain-free, although the close quarters of the testing machine can be unnerving.
    Sallach said cardiac MRI has been around for 10 to 12 years now but this is the first time it's been done locally.
    Now that the software is here, she expects to see many more take place.
    "This is an emerging technology and I imagine we'll do hundreds a year," she said.
    The charge for a cardiac MRI runs between $1,300 and $2,600, depending on the extent of the testing.  Sallach said most insurance companies will reimburse for the procedure, which takes about 30 minutes.