— It was a different world of health care when Dr. Magdi Azer and his partner, Dr. Ali Samii, pushed to add open heart surgery to their cardiovascular and chest surgery practice.

Instead of a hospital’s launching the program and hiring the surgeons, the early 1970s move was driven by the independent local doctors.

Even then, it took some wheeling and dealing by the medical community to get the short-lived program off the ground, Azer said at his Westmont home.

The longtime Johnstown surgeon recalled those first steps into cardiovascular procedures during an interview to preview his induction Saturday as the first member of Cambria-Somerset Heart Hall of Fame.

A native of Egypt, Azer was completing his training at the former St. Francis Hospital in Pittsburgh in 1971 when several other medical residents encouraged him to locate in Johnstown. Since his new wife, Karen Azer, was from western Pennsylvania, Azer was inclined to stay in the area.

“I called them to see if there were still openings in Johnstown,” Azer said. “They said, ‘Come on out and see.’ They showed me around. We liked the area. We decided to move here and take our chances.”

Although his colleagues assured him there would be plenty of work in his specialties, Azer said he knew he was taking a risk. “I opened an office and tried to get patients,” he said.

The next step was to start building a program.

Along with Samii, Azer began introducing procedures to the area. He did the first pacemaker implant, the first cardiac endoscopy and others.

When they decided it was time to introduce heart surgery, they needed a hospital to sponsor the program. Memorial Medical Center was willing, but everyone knew there would be a problem, Azer said.

New programs had to be approved by a state agency, which required detailed information about the  proposed program, expected number of patients and nearby alternatives.

Competitors would also get their say.

“At that time there was really fierce competition between Memorial and Lee (Hospital),” Azer said. “We knew Lee would object. We were going to be turned down.”

So Azer and his colleagues negotiated an agreement that allowed the heart program to be recognized. Memorial would have the surgery program, but Lee would have the heart catheterization lab.

Cardiac rehabilitation patients would be sent to Mercy Hospital.

Now all three Johnstown buildings are part of the Conemaugh Health System.

“After we got organized we did the first open-heart surgery in December 1974,” Azer said.

Despite what he called “good” outcomes, the program did not last more than three years.

State regulations again came into play, along an unlikely obstacle: The weather.

Officials were looking to provide quality assurance for health care, Azer explained. A commission was formed to determine minimum requirements for various procedures, including heart surgery. Azer was named to the commission.

“Bigger hospitals in Philadelphia and Pittsburgh were planning to stop the newer hospitals by requiring a big number of cases,” Azer said.

After discussion all the pros and cons at two commission meetings, there was a motion to require 250 procedures a year. But the motion was voted down. A second motion by a smaller hospital’s representative was passed, Azer said, setting the minimum at 150 a year.

New programs were given a period of time to achieve the minimum.

“In Johnstown, because of the catheterization in one hospital and surgery in another, our number never materialized,” Azer said.

To further douse the program, the 1977 Johnstown Flood shut Lee’s catheterization lab for a several weeks, sending all heart patients out of town.

“We were almost reaching the (deadline),” Azer said. “We figured out we’d never make that number. We decided to voluntarily stop the program.”

It was another 14 years before open heart surgery again was performed in Johnstown.

“In 1991 they started a new program,” he said.

“They did it the right way – with the cath lab in the same building.”

Drs. Rajsekhar Devineni, Jack Kolff and Robert G. Stenberg launched the current program, with Dr. Savas Mavridis joining several years later.

In the years since, the need for heart surgery has decreased, Azer noted.

Advances in catheterization, angioplasty and stents have reduced the number of simple bypasses.

“This is a much easier procedure.” he said. “You go home the next day. You don’t have any cuts. It is a big improvement. We used to keep them at least for a week.”

Azer said he is “deeply honored” to be the first inductee to the Heart Hall of Fame during Saturday’s Cambria-Somerset Heart Ball at Sunnehanna Country Club.

“I hope that brings more people to recognize the problem of heart disease,” he said.

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