Officials at two local hospitals claimed a partial victory Friday when Gov. Joe Manchin signed an order that allows medium-sized West Virginia hospitals to perform emergency procedures to clear clogged heart arteries without onsite surgical backup.

Manchin did, however, ask the state Health Care Authority to rework what he called ambiguous wording on the proposed rule for elective angioplasties.

Manchin spokeswoman Lara Ramsburg said the rule the governor rejected says hospitals could not do elective angioplasty if they are ''within one-hour medical transport drive time'' from another facility that has a heart surgery unit.

Hospitals want to know if that one-hour window means drive time only, or includes the time it takes to prepare a patient for transport.

''They need to know specifically,'' Ramsburg said. ''We don't want any ambiguity, any confusion.''

Sonia Chambers, chairwoman of the Health Care Authority, said the board already has begun looking at how to clarify the language and expects to address the issue at its next meeting July 30.

Ohio Valley Medical Center is one of the hospitals pushing for the rule change. Spokeswoman Maggie Espina said Friday's signing was a good first step.

"We are encouraged by Gov. Manchin's position regarding angioplasty services. We support the position of the West Virginia Health Care Authority, we support the standards they have proposed and we will wait to see what the final outcome is."

Being allowed to do more than emergency angioplasty procedures could be an important factor for a facility such as OVMC. Wheeling Hospital, which has a heart surgery unit, performed only 168 emergency angioplasty cases last year of the 574 total angioplasty cases it handled.

"Our concern has and continues to be about quality patient care and safety in addition to controlling health care costs," said Gregg Warren, Wheeling Hospital spokesman.

Weirton Medical Center is one of three hospitals participating in a five-year pilot project involving primary angioplasty, done when a patient is in crisis, and elective angioplasty, which is more preventive. Angioplasty can relieve symptoms such as chest pain and shortness of breath, and can be used during a heart attack to quickly open an artery and minimize damage.

Dr. Joseph Endrich, chief executive officer at Weirton Medical Center, said "I'm very pleased and excited for this opportunity to be able to serve the community with our angioplasty program. I'm looking to see what the exception that was included in Gov. Manchin's decision will mean for Weirton Medical Center, but at this point, I certainly view the action as extremely positive."

West Virginia, which has a high rate of heart disease, also is rural and challenging to travel. A 30-mile drive over twisting mountain roads can easily take an hour, and it can be difficult for people to get to cardiac-care centers.

The pilot project also included St. Francis Hospital in Charleston and United Hospital Center in Clarksburg and has been successful, showing good results regardless of whether a heart surgeon was on site, Chamber said.

Weirton Medical Center's statistics show that out of nearly 900 procedures performed during the pilot project, just one patient was sent to a major cardiac center for further treatment.

Doctors around the state have lobbied for the change, arguing that every minute an angioplasty is delayed, the more a heart is damaged.

Besides the three hospitals in the pilot project, the move to change the rule was backed by Bluefield Regional Medical Center, Cabell Huntington Hospital, Camden-Clark Memorial Hospital, OVMC and Thomas Memorial Hospital.

Larger facilities such as Charleston Area Medical Center, St. Mary's Hospital in Huntington and Wheeling Hospital had objected, arguing the new rules would endanger patients and increase health care costs.

''We have taken hours of testimony, pored over thousands of pages and studies and we have looked at the quality issues, the access issues and the financial issues,'' Chambers said.

''We thought it was really important to provide the standard of care to people where they can get it quickly, and that outweighs the small risk that might occur if a complication arises,'' she said. ''I think we're going to save a whole lot more people than (we) endanger.''