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3 ways the VA keeps your heart pumping

gettyimages 187072849 3 ways the VA keeps your heart pumping

A surgeon and an assistant surgeon operate on a patient a patient during an open-heart surgery (Jean-Sebastien Evrard/AFP/Getty Images)

By Jonathan Kaupanger

The Study

VA doctors have figured out how to give veterans undergoing open heart surgery an additional 28% chance of survival.

Involving 18 VA Medical Centers, the five-year follow-up study measured how many patients died – from any cause – following heart surgery.   More than 2,200 veterans, who had heart bypass surgery between 2002 and 2007, were randomly assigned either the traditional on-pump or the relatively newer off-pump surgery.  Patients with the on-pump operation had an 11.9 percent rate of death while the off-pump patients died with a slightly higher rate of 15.2%, representing a 28 percent higher risk of death.

The on-pump type of surgery puts a patient on a heart-lung machine, allowing the surgeon to stop the patient’s heart while preforming the procedure. It’s been in use since the 1950’s. The off-pump – also called beating heart surgery – was developed in the 1990’s. In this process, the surgeon doesn’t stop the heart while preforming a graft to remove blocked arteries.

Another part of this study tracked major cardiac events like nonfatal heart attack or a need for repeat heart surgery. The on-pump group won with this as well, showing a 27.1 percent rate of these issues where the off-pump group climbed to 31 percent.

The result of the study shows that the on-pump method should be used for most patients receiving heart bypass surgery. The off-pump surgery should still be used if patients have unusual clinical factors such as a stiffened aorta.

The App

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In testing now, VA’s FitHeart app is specifically for veterans. (VA photo)

If you’ve had a recent heart attack or other heart problems, the VA is testing an app that will help with your cardiac rehab.

It’s called FitHeart and the unique thing about this app is it’s designed specifically for veterans.

According to the American Heart Association, cardiac rehab lowers death rates and eases symptoms like fatigue and chest pain. But studies show that less than 20% of eligible patients take part in cardiac rehab.  The VA hopes this app will make this type of rehab more attractive to veterans.

There are four parts to this app: goal setting, logs, health education and reminders. The data collected by the app is sent to the new VA Patient Generated Database.

The app is in local testing right now but will be opened to a wider field test later this year. Veterans interested in field-testing the app can contact project lead Dr. Alexis Beatty at alexis.beatty2@va.gov, or her project coordinator, Sara Magnusson at sara.magnusson@va.gov.

The Phone

Scientific studies show that people who have a cardiac event can increase the likelihood of recovery if they take part in an organized rehabilitation program. Those who complete a cardiac rehab program can increase their life expectancy by up to five years, have 27% lower death rates, are 25% less likely to have another heart attack and have an all-around improved quality of life.

Veterans from more rural areas have geographic and financial barriers that prevent them from accessing this type of rehab. The VA’s Office of Rural Health has created a telephone-based rehab program that delivers in-home cardiac rehabilitation.

Veterans first meet with a specialist in person – usually a physical therapist or registered nurse to learn the correct way to do the exercises. Once they are comfortable with the routine the following exercise sessions are at the veteran’s home and the nurse or therapist joins by phone.  There are also regularly scheduled phone calls with a rehab specialist to go over things like risk factors, smoking cessation, and proper nutrition.

In the VA’s pilot program, the veterans who lived in rural areas and elected to use this home-based program reported a higher satisfaction and a higher rate of program completion when compared to vets who used only on-site facilities.

The next step for the VA is to integrate local Community-Based Outpatient Clinics into this program that includes video telehealth support.

Connect: @JonathanVets1 | Jonathan@ConnectingVets.com

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