Dr. John Anastasi called it the most exciting time of his life.
Sept. 7 will mark the 25th anniversary of the first open heart surgery performed - by Anastasi - at then Altoona Hospital.
"I remember the night before the first surgery, I doubt if I slept a second. It was the only operation I have done when in the middle, my hands were shaking because there was so much riding on the success of that first surgery," Anastasi recalled. "It was a thrilling time, there was so much support from the hospital, the nurses and administration. Everyone wanted this to be successful. It was a team effort, it was surprising how immediately everyone was so receptive. If we didn't have success early on we would not have established credibility."
Dr. John Anastasi says the hospital does more valve replacements than bypasses today.
Shari Gilbert adjusts a monitor for Dr. John Anastasi to view during the bypass operation of a 79-year-old man.
The first patient was Dean Campbell, 71, of Curwensville, who underwent a 21/2 hour triple coronary artery bypass. The procedure involved removing a portion of vein from his leg and a portion of artery from his chest wall and using those to channel blood around three clogged arteries.
"He was a very brave man to say I will be the first one," Anastasi said.
Jacquie Strawser, who became one of the first "open heart nurses," said it was a very exciting time.
"Everyone was talking about who would be the first patient, what day it would be, who would be taking care of the patient on all three shifts and how many surgeries would we start doing. There was electricity in the air."
"Everyone could feel this was the beginning of something big for Altoona. It was truly fulfilling and a wonderful experience being part of something that was making such a difference in so many lives," Strawser said.
Strawser, who today is director of critical care in the open heart unit, took care of Campbell on the 3 to 11 p.m. shift the day of his surgery.
"I was a staff nurse at that time, and everyone came in to help me and make sure everything was going smoothly and according to plan. There were so many lines, wires, monitors and machines on the patients back then - it looked very overwhelming to a lay person," Strawser said. "The docs stayed in the hospital 24/7 the first few weeks till we all felt comfortable taking care of the patients - we always knew they were only a phone call away."
Kitty Zelnosky worked in the medical progressive care unit - where patients go after they come out of intensive care - at the time.
"It was very humbling. It was very satisfying to watch the transition from someone you are caring for, to have their lives in your hands, and bring them back to where they are safe and healthy," said Zelnosky, who today is nurse manager of the cardiothoracic unit at UPMC Altoona.
In the early days of the program, Anastasi and his then partner Dr. Burt Fazi, did more open heart surgeries than expected.
"When we started, the hospital wanted us to do 75 the first year, we did 150. The second year they wanted 150 and we did about 300. We always exceeded their expectations," Anastasi said.
Over the years, the numbers have dropped.
"For the first ten years, we did five hearts a day on healthy 50-60 year old men. They didn't have any other major diseases. During the last ten years, the average patient is in their late 70s to early 80s and they are much sicker. There is nothing left for them but surgery. There is a whole different set of patients we take care of. I am operating on much sicker patients. It takes longer, and I am doing more complex surgeries," Anastasi said.
The surgery itself has changed.
"The basic bread and butter open heart surgery involves splitting the sternum, putting the patient on a bypass machine and stopping the heart to do a bypass or heart valve replacement," Anastasi said. "Today, about 70 percent are done without a bypass machine, called beating heart surgery. Most bypasses are done minimally invasive so the sternum is not split."
Today, the hospital does more valve replacements than bypasses, Anastasi said.
Anastasi said over the years open heart surgery has become routine.
"They are routine but always difficult. When you have an operation on your knee or shoulder it is not associated with the death of the patient, with open heart surgery there is always a possibility of the person not surviving. It is a big deal when playing with a heart," Anastasi said.
The start up of open heart surgery - the hospital had announced in April 1988 that it was initiating the program - was very important to the hospital.
"It was a huge deal. This was really needed. We became the only hospital doing open heart surgery between Pittsburgh and Hershey. When anyone in our community or surrounding communities was diagnosed with heart disease they had to travel a long distance and be inconvenienced," said James Barner, Altoona Hospital chief operating officer at the time. "It was the right thing to do for our area. At the time Altoona Hospital was a community hospital with specialists and subspecialists, this was the first type of tertiary care program, that was significant for the community and the hospital, it put us on the map."
Fazi said the introduction of open heart surgery elevated the hospital to become more of a critical care hospital.
"They had to do post operative care and training of auxiliary personnel. This put Altoona Hospital in line with other hospitals, It enabled patients to be treated at home rather than going to a larger city, it made it more convenient for them and their families," said Fazi, who teamed with Anastasi before leaving in 2012.
"Before, we had to ride in the back of an ambulance to take the patient to Pittsburgh or Hershey. The family would ride along. When Dr. Anastasi and Dr. Fazi came, that went away. We were able to serve people in a better way. That fact was missed a lot but that stands out to me as a nurse," Zelnosky said.
The quality of open heart surgery in Altoona is as good as anywhere in the world, said Anastasi, a Long Island, N.Y., native who came to Altoona from Canton, Ohio, where he served as chairman of the thoracic surgical division of the Canton Heart Institute of Aultman Hospital.
"If my parents were alive and they needed open heart surgery, I wouldn't take them anywhere else," said Joel Connolly, a surgical assistant to Anastasi, who has been part of the team since December 1989.
Team members speak highly of Anastasi, whose title today is chairman of the Cardiac Surgery Department at UPMC Altoona.
"He is fun to work with. He is very personable. He is not the typical cardiac surgeon. A lot of them have an arrogance about them; he does not. He is extremely, caring about his patients," Connolly said.
"Dr. Anastasi was dynamic, intelligent, funny, and articulate. Very fast paced, always moving and thinking - he was the 'go-to' guy. We all thought there was nothing he couldn't handle," Strawser said. "Dr. Anastasi and his dedicated, loyal, and hardworking team helped to make the program a success 25 years ago."
Barner looks back at the establishment of the open heart surgery program as a major accomplishment.
"I think it is a fantastic accomplishment and a tribute to the very talented staff at the hospital who has worked on the program over the years. Any time you put a complex program into a community hospital and do it as successfully as we did speaks to the tremendous dedication of all those involved," Barner said.
UPMC Altoona is one of six hospitals of UPMC performing open heart surgery (the others are Hamot, Passavant, Mercy, Presbyterian and Shadyside).
The UPMC Heart and Vascular Institute is making a significant investment in the advanced Heart and Vascular Program at UPMC Altoona by continuing to recruit additional cardiac surgeons, invest in minimally invasive valve repair/replacement technology and increasing advanced heart failure expertise in the Altoona region.
"As cardiovascular care remains one of the most rapidly changing fields in medicine, the goal is not simply to increase the volume of any specific procedures but to make sure we are providing the most advanced, highest quality heart and vascular care possible to every person in the Altoona region," said Dr. Joon Sup Lee, co-director of UPMC Heart & Vascular Institute and chief of the division of cardiology at the University of Pittsburgh School of Medicine. "As UPMC Altoona's cardiac surgery program celebrates its 25th anniversary, we are confident UPMC Heart and Vascular Institute's continued investment will insure the continued growth of heart and vascular services in Altoona."
Mirror Staff Writer Walt Frank is at 946-7467.