Photo by Doug Koontz Frederick Memorial Hospital’s Sue Calhoun works at the new emergency angioplasty lab.

Until this month, people who came to Frederick Memorial Hospital with a blocked artery received clot-busting drugs and were taken to hospitals in Washington or Baltimore for emergency angioplasties. Including transportation, some patients waited more than two hours to have their arteries opened, suffering irreversible heart damage.

Heart attack patients can now have this potentially life-saving operation performed closer to home. The hospital was approved by the state March 13 to perform primary angioplasties, and cardiologists have since treated four patients.

Carl Raudabaugh, of Boiling Springs, Pa., is one of them.

Raudabaugh and his wife, Barbara, were driving to Purcellville, Va., on Saturday to visit their son. They stopped at the Cozy Restaurant in Thurmont to have lunch, and Carl was three bites in when he started having chest pain.

He went outside to get some fresh air, but the pain didn't stop. The couple went straight to the Thurmont Community Ambulance Company, whose members took them to FMH.

In little more than an hour, his blocked artery was reopened and he was recovering in his hospital room.

It was Raudabaugh's first heart attack, and having the surgery available at FMH saved his life, the 79-year-old said through tears Monday.

Cardiologists recommend that "door-to-stent" time, or the time between when a patient comes through the hospital door and when a stent or balloon opens their blocked artery, should not exceed 90 minutes.

The national average door-to-stent time is more than three hours in communities without a primary angioplasty program, said FMH cardiologist Dr. John Vitarello. Each of the four operations at FMH in the past two weeks at were done in less than 80 minutes.

"With transportation, there were a lot of logistics, and there was no way of doing that (under 90 minutes) before," said hospital spokesman Harry Grandinett.

The hospital has also begun both emergency and elective cardiac catheterizations, the diagnostic imaging that finds blocked arteries. A new $1.6 million catheterization lab opened at the hospital March 14, and technicians are performing about four diagnostic catheterizations per day, Grandinett said.

An experiment by Johns Hopkins first brought primary angioplasty programs to community hospitals in 2005 through the Cardiovascular Patient Outcomes Research Team program, or CPORT. FMH is now one of 12 hospitals in Maryland to offer the procedure, Vitarello said, and CPORT hospitals must meet strict guidelines to retain state approval.

All participating cardiologists must have intensive angioplasty experience, in terms of both years and number of cases. All five cardiologists approved to perform primary angioplasties at FMH were recruited from Washington Adventist and Johns Hopkins hospitals.

For patients who have complications, the hospital must have five modes of transportation available to take them to centers in Baltimore or Washington.

The interventional cardiology team also relies on LifeNet, a real-time electrocardiogram system that transmits the patient's EKG reading from the ambulance to FMH's emergency department. If doctors determine from the EKG that the patient is an angioplasty candidate, they can immediately page the interventional cardiology and catheterization teams, reducing wait time once the patient arrives.

"This is the only program that has required as much time, effort and expense É (the hospital) realizes how important this project is," Vitarello said.

In about six months, or when the hospital has at least 18 successful emergency angioplasties under its belt, it will apply for approval to perform elective angioplasties on site, said cardiologist Dr. Stephen Williams. Elective procedures are reserved for hospitals with on-site cardiac surgery units, or those with demonstrated success in emergency angioplasties, he said.

Williams said the hospital could perform more than 100 emergency angioplasties over the next year.