San Jacinto Methodist Hospital
Heart and Vascular Center
By: Fabian Sandler

Cardiovascular disease has accounted for more deaths in the United States than any other single cause for all but one of the last 113 years.   Nearly 2,400 Americans die of heart and vascular disease every day, an average of one fatality every 36 seconds.
San Jacinto Methodist Hospital is doing something about that.
In 2011, the hospital opened its Heart and Vascular Center, comprised of Dr. Wade Fischer, cardiothoracic surgeon, and Dr. Jacobo Nurko, vascular surgeon. Both doctors are affiliated with the Methodist DeBakey Heart & Vascular Center.  In just a short amount of time, the Center has already achieved an outstanding milestone. In November 2012, San Jacinto Methodist celebrated the Heart and Vascular Center’s 100th open heart surgery since opening in 2011.
Dr. Wade Fischer states that the hospital has maintained a remarkable zero percent mortality rate, even with the varying complexities of the cases experienced.   The procedures are performed in the hospital’s state-of-the-art cardiovascular operating room, which houses the latest technology in the field.
February 2013 was the two-year anniversary of the Heart & Vascular Center, which marked the start of offering open heart surgery to the Baytown and East Houston communities.  To celebrate the anniversary, a luncheon was held and free health screenings were provided to guests.

“The success that we’ve experienced is without question a direct result of the great teamwork and collaboration that takes place every day at San Jacinto Methodist Hospital,” states Donna Gares, president and chief executive officer of San Jacinto Methodist.  “We are grateful for the various teams and physicians for their hard work and dedication to our patients and the cardiovascular program.”  
During the celebration, Dr. Fischer pointed out, “We have an excellent staff of people.  In order for a program like this to be successful, it starts with a commitment from the administration to provide resources to make a successful program.  They enabled us to achieve outcomes that I think would be the envy of any of the hospitals in the area.”
Because the Center handles both cardiovascular and vascular cases, it is sometimes difficult for people outside of the medical field to understand the difference between the two. As the Center’s vascular surgeon, Dr. Nurko has aimed to raise awareness of vascular surgery since he began practicing in Baytown in 2010. 

“A lot of people don’t know what vascular surgery is,” Dr. Nurko begins to explain.  “Vascular surgery is basically treating all of the arteries and veins outside the heart.  Over time, the field has evolved into more minimally-invasive therapy. The treatments that were previously accomplished by open surgery can now be resolved using a minimally-invasive method.”  The surgeon works on all arterial areas, including carotid arteries, the aorta and arteries that provide blood to organs and legs.
“Another area of work – an important one in my practice – is renal failure, or when kidneys do not work. Patients need what’s called kidney replacement therapy, or hemodialysis,” says the doctor.  During dialysis, blood is taken from the patient, cleaned by a machine acting as an artificial kidney, then returned to the patient’s body. Dr. Nurko states that the most ideal way for patients to get dialysis is through an arteriovenous fistula (where an artery and vein are sewn together) preferably created on the arms. This technique is preferred because it has fewer complications and lower infection rates.  
Dr. Nurko usually performs from one to three surgeries, depending on complexity, in the mornings and sees patients in the afternoons for pre- and post-surgical consultations.  Every Monday, Dr. Nurko dedicates his time to wound care through San Jacinto Methodist’s Wound Care & Hyperbaric Medicine program. 

“I deal with circulation. My job is to improve circulation.  I make sure that patients who develop wounds due to poor circulation are healed.”  He explains that there are multiple factors involved in healing those wounds, but the main one is circulation.  “If there’s no circulation reaching that wound, it’s not going to heal,” he attests, adding that it’s more common in older people, but young people who are heavy smokers accelerate the arrival of other diseases such as heart disease.
“Another big component of the wound care is venous insufficiency – when your veins do not work well.  The heart is a pump. The heart pumps blood to all of the body through the arteries.  All that blood needs to come back to the heart to finish the cycle through the veins.  The veins in the legs need to fight gravity in order to effectively return the blood.  When they don’t do that, it’s called venous insufficiency. When those legs aren’t working well, all that blood pulls into the legs, creating swelling, pain, increased pressure and inflammatory response that can lead to ulcers. This is very costly and difficult to treat, and the ideal is to identify early so it can be prevented.” 

Dr. Nurko has worked and trained extensively in his field. Originally from Mexico City, where he attended medical school, he completed his general surgery residency in Little Rock, Arkansas.  He spent the next three years at Baylor College of Medicine for his fellowship in vascular surgery.  Counting medical school, it’s been a 14-year ride to follow his dream of becoming a vascular surgeon. He is double board certified by the American Board of Surgery and American Board of Vascular Surgery. He is only one of about 3,000 vascular surgeons in all of the United States.
An interesting fact that Dr. Nurko mentioned is the amount of time he spends preparing for surgeries using imaging advanced technology. Through CAT scans and measurements that define the patient’s anatomy and other research, he enters the operating room already equipped with the knowledge of how to precisely carry out the procedure.  Somewhat surprisingly, most of Dr. Nurko’s procedures can be done on an outpatient basis.  
In early March 2013, San Jacinto Methodist opened a new Ambulatory Surgery Center (ASC), where such surgeries can be performed. The ASC, located at 1677 West Baker Rd. in Baytown, also has state-of-the-art surgical equipment.
“This new facility allows easy access, convenient scheduling, highly trained and experienced physicians and staff,” says Gares of the 12,000 square foot facility.

The team that surrounds Drs. Nurko and Fischer is dedicated and highly-qualified.  Eric Garcia, RN is the clinical coordinator of the cardiovascular program and is an important part of the Center’s daily activities.  Amy Luczaka, physician assistant, closely assists both surgeons in the operating room and during office visits.  And if you call or visit the doctors’ office, located at 4301 Garth Road, Suite 212 in Baytown, you’ll be greeted by the office manager Faye Chenier-White and medical assistant Jennifer Fingleman.
In addition to the skilled team at San Jacinto Methodist, Dr. Nurko also appreciates the investment the hospital makes in cutting edge technology.  “Not every hospital has the luxury of having a hybrid [operating] room.  The advantage of a hybrid room is that I have total control of offering the best option to the patient.  Instead of doing one part first in the Cath Lab and then bringing the patient back to the operating room, you’re right there.”  The hybrid operating room allows physicians to perform both complex catheter-based therapy and open vascular surgery in one singular area.  It effectively combines the abilities of an OR and an advanced catheterization room.  San Jacinto Methodist currently has the only such room in all of East Houston.

Even when he was younger, Dr. Nurko knew he would end up in the medical field. “Ever since I can recall, I’ve always wanted to be a doctor,” he reflects.  In Mexico, medical staff like doctors and residents wore white uniforms.  On weekends when he worked as an EMT, he and a friend from the ambulance service would wear white and go to the hospital.  “We’d get into the emergency room through the back door where the ambulance [would park],” says Dr. Nurko.  “They see you wearing white, you must be a doctor!  They started giving us tasks and stuff to do. That was a really good way for us to be exposed and realize that this is what we wanted to do.”
It’s a good thing that Dr. Nurko decided to wear a white uniform and sneak into the ER.  He and the team he is a part of have helped San Jacinto Methodist’s Heart and Vascular Center become a great success in just three short years.
For more information on heart and vascular services at San Jacinto Methodist, you may call 832-556-6625 or visit www.sanjacintomethodist.com.