FLORENCE — The quality and need for an open heart surgery program at Eliza Coffee Memorial Hospital was debated during Day 2 of the contested-case hearing on two proposed new health care facilities in Florence.

Attorneys representing Helen Keller Hospital during the proceedings presented data from 2004-11 that they said showed a decline in the number of open-heart surgery procedures and cardiac catheterization procedures at ECM Hospital. They alluded to the conclusion that open-heart surgery services were not proficient or needed at ECM.

Helen Keller Hospital is opposing the proposal to build a 300-bed replacement hospital and comprehensive cancer center in Florence.

Dennis Nabors, attorney for Helen Keller Hospital, asked Dr. Constantine Athanasuleas about the offering of interventional cardiology without the presence of an open-heart surgery program. Nabors said that is allowable under the Alabama State Health Plan and is happening in other parts of the state.

Athanasuleas, a cardiothoracic surgeon at ECM, said complications from interventional cardiology, which is commonly called angioplasty or stenting, are relatively rare but can be deadly if open-heart surgery isn't present as a backup.

"That is a question of (whether it is) legal or ethical," he said. "Ethically, I'd say ‘no.'"

On Monday, Nabors asked Marty Rash, RegionalCare CEO, about the state of the open-heart surgery program prior to the arrival of Athanasuleas and cardiovascular surgeon Dr. Denis Raleigh.

"Prior to them coming here, open heart (surgery) was almost in crisis?" Nabors asked Rash.

Rash replied: "I think that is a bit of an exaggeration, but it needed improving."

Nabors said open-heart surgeries have dropped from 173 in 2008 to 126 in 2012.

Rash said Monday, with two surgeons, ECM is performing approximately 20 open-heart procedures and 10 vascular procedures each month.

Athanasuleas said Tuesday that this week he and Raleigh have approximately five procedures already scheduled with additional patient consultations occurring routinely.

ECM is the only local facility equipped for open-heart procedures and interventional cardiology procedures.

Florence-based cardiologist Dr. William Heaton also testified to the state of and need for interventional cardiology services in the Shoals. He said when he came to the Shoals in 1978 it was his "goal to do state-of-the-art cardiology in a community hospital."

Heaton helped write the certificate of need for the first cardiac catheterization lab at ECM.

Nabors showed a graph that indicated fewer catheterization procedures have occurred at ECM in the past few years. Heaton attributed that to better health care and better prescription drug treatment.

"But, 2,800 procedures is a lot of procedures," Heaton said.

Nabors responded: "My point is, it is going down."

Helen Keller Hospital has listed Dr. Doss Cleveland as a witness for their case. He is the former cardiothoracic/vascular surgeon at ECM. Helen Keller is expected to begin calling its witnesses next week.

Alliance Oncology, which operates two radiation oncology clinics in the Shoals, has opposed the duplication of services that could exist if an additional radiation oncology service is created. Alliance, during the hearing, has showed willingness to work with ECM representatives on a possible partnership.

Jennifer Edwards can be reached at 256-740-5754 or jennifer.edwards@TimesDaily.com.

Witnesses

Tuesday's testimony

• Linda Marzialo, architect, testified about the design process and plans for the proposed replacement hospital and cancer center.

• Damon Greely, engineer, testified to the disrepair of the hospital and the cost of repairs to the mechanical, electrical and plumbing systems at ECM.

• Sam Pendleton, former Florence city councilman, testified to the need of a new hospital in Florence.

• Dr. Constantine Athanasuleas, cardiothoracic surgeon at ECM, testified to the need of an open heart surgery program at ECM.

• Dr. Edsel P. Holden, Florence pulmonologist, testified to the need of a new hospital.

• Dr. William Heaton, Florence-based cardiologist, testified to the level of treatment provided by local cardiologists and the need for a new hospital.

Today's planned witnesses

Phyllis Johnson, construction consultant for NoliWhite Group; Ken Fennell, division manager of preconstrcution for Robbins & Morton, a general contracting firm; Van Morgan, Florence resident; Herman Graham, Dave Smith and Andy Betterton, Florence city council members; Larry Irons, D.C. Thornton and Roger Garner, Lauderdale County commissioners.