Since 1982, UnityPoint Health-Allen Hospital, along with Cedar Valley Medical Specialists, has been providing the Cedar Valley and surrounding communities with full-spectrum cardiac care. This care has been provided by a team of board-certified cardiologists and cardiothoracic surgeons.
Cedar Valley Cardiovascular Center is located at 419 E. Donald St. in Waterloo. At the center, which is under the direction of Dr. Kalyana Sundaram, area patients experience the best in care with the latest technology and procedures, all with the center’s aim of keeping hospitalization and overall costs minimal.
Allen Hospital was ranked one of the 2014 Top 50 Cardiovascular Hospitals in the United States by Truven Analytics for the last few years. Allen performs approximately 160 open heart surgeries and over 3,000 other cardiac procedures, including stent placements, each year.
“We are not shy about taking credit for Allen’s recognition because we are the exclusive cardiac care for Allen Hospital,” Dr. Sundaram notes. “It is a good partnership.”
The Cardiovascular Center recently has completed an expansion of services, allowing for concise, patient-friendly outpatient cardiac care. There are five cardiologists, four of whom are interventional cardiologists, and one electrophysiologist, all of whom treat those with rhythm problems. The team is supported by a board-certified cardiac surgeon who provides inpatient and outpatient care.
Also on staff are seven board- certified ARNPs who work closely with the physicians, three nuclear technologists, two pacemaker nurses, eight ultrasound sonographers, 10 nursing personnel, and seven support staff and billing specialists.
The Cardiovascular Center includes a large pacemaker clinic for those who need to have devices checked on a routine basis, and an Enhanced External Counterpulsation (EECP) Department for those outpatients needing treatment for severe angina who are not candidates for stents or bypass surgery.
“Functioning in one place makes logical sense,” Dr. Sundaram says. “We can keep all patients and care teams here so we can focus and concentrate on all the needs of our patients. We operate as a group. We work well together as a team. If someone is sick, we can provide care right away. We have all the resources needed to provide the full spectrum of cardiac care with both outpatient care in our office and inpatient care at Allen.”
Dr. Sundaram says his team deals with heart attacks and congestive heart failure, among many other conditions, along with the vascular system, which deals with the blood vessels going to and from the heart. Vascular medicine, just like heart medicine, treats the entire disease process, not just the symptoms.
“Heart disease is one of the most common diseases in Western society,” he says, “but is declining in incidence rates because we as a society have done very well in reducing the number of people who smoke. That is showing its effects on the incidence of heart disease.
“Also, the medical community in general has done well in the treating of cholesterol. Still, heart disease is a burden on the system.”
Dr. Sundaram says obesity and lack of physical exercise remain problems. “This country has not done a good job in terms of physical exercise and healthy eating,” he says.
In addition to the more well-known heart-related diseases, the center is seeing many sleep apnea patients. Sleep apnea can have a large affect on the heart function.
“People snore and they stop breathing for a period of time,” Dr. Sundaram explains. “That can directly lead to heart arrhythmia. It can lead to congestive heart failure and it significantly increases the risk of stroke. If a patient comes in and they have sleep apnea, unless you treat the apnea, you are not going to get the fibrillation better.”
Dr. Sundaram says doctors have multiple roles to play. Saving lives is a top priority, but they also need to consider how the patient will be functioning three, five, or ten years later. Making an early diagnosis can be paramount. It’s also important to manage the disease well so it does not cause long-term disabilities.
“Our motto is not ‘just fix it when it’s broken,’ but ‘once you fix something, make sure they live well.’ We live long, but living long doesn’t matter if you don’t have a good quality of life. We do everything possible so patients live healthy lives and remain healthy. This will allow them to live as long as possible in their own homes. It’s less expensive, they’re happy and they’re self-sufficient,” Dr. Sundaram says.
“We live long, but living long doesn’t matter if you don’t have a good quality of life. We do everything possible so patients live healthy lives and remain healthy.”
He says the national trend is to treat patients in their own environments. “Hospitals are good if you are very sick, but if you don’t need to be admitted, you get to stay where you are and get treated. Our practice has done that very well. We have consciously made an effort. Our role as cardiologists doesn’t stop in the cath lab. We feel heroic when the outcome is good, but we want to make sure patients live healthy lives so they do not need to be in the hospital.
“We see the patient, we educate them. Seeing them in the office is very effective because we can address their lifestyles and all other health issues before they become severe. Outpatient care is very key in patient education,” he notes.
Besides the quality of care and the cost of care, the providers with the Cedar Valley Cardiovascular Center also pay attention to access to care. They travel to Sumner, Grundy Center, West Union, Independence, Waverly and Oelwein to make it easier for patients.
“It’s important to take care of patients on a periodic basis so we don’t wait for conditions to worsen,” Dr. Sundaram explains. “If we wait until they need to be hospitalized, it could be too late.”
Access to care also is addressed with the team of nurse practitioners who can treat a patient at certain levels. They have their own state licenses, and they have extensive training and experience in cardiology. Each doctor and each practitioner focuses on a particular niche, whether it be diet, EECP, devices like pacemakers or sleep apnea.
Dr. Sundaram says medicine as a whole will be moving away from the hospital- based system. Better coordination of care needs to come with that. “We’re good in specialized things in the U.S., but we haven’t been good in coordinating things well. It’s not something one physician can do alone. It is a team effort.
“Sharing of information is important. Patients can be and will be monitored from home, take blood pressure from home — all the telemedicine advancements are done to improve the quality of care and life.”
He says the future of cardiology is “very exciting.” A lot of gene research is being done, including gene therapy for high cholesterol. There will be tremendous advancements in the coming years.
“As doctors, we don’t just treat heart attack patients. This is our community. We are a part of our community. Our goal is to study the community needs and do everything possible to make those in our community live long, healthy lives.”