Gwinnett Medical Center got state approval Thursday to establish an open-heart surgery program in Lawrenceville.

The Georgia Department of Community Health approved the hospital's Certificate of Need application for a $33 million cardiovascular center. The hospital filed for the certificate in January but the effort actually began last October, when the hospital created a dedicated Web site for the cause — www.openheartgwinnett.org — and began spreading the word.

In the process, GMC collected 1,000 letters and testimonials from local residents supporting its quest for a complete cardiovascular center.

"An open heart program for this community has been a critical component of ... GMC's strategic initiative," said Phil Wolfe, president and CEO of Gwinnett Medical Center in a statement. "This is not only a point of pride for our organization; it should serve as a point of pride for Gwinnett."

The CON paperwork noted that Gwinnett County has consistently produced more than 400 adult open-heart surgery patients annually. In 2006, Gwinnett produced the second most adult open heart surgery patients in its region, which includes Fulton, Cobb and DeKalb, the documents stated.

GMC's director of cardiology called the news "absolutely delightful."

"It's something that has, in my opinion, been way overdue — but it's never too late," said Dr. Manfred Sandler. "It will allow us to take a hospital system that already provides excellent care to the next level, and provide all-round care for the citizen of Gwinnett County — which already has the second largest population of all counties in Georgia, and by 2010, probably the largest."

In making its case, the hospital noted the many instances in which time was not on the side of Gwinnett's medical team, which has to transport patients to one of the seven other metro open-heart programs. The closest, St. Joseph's Hospital in Sandy Springs, is 20 miles away. The hospital also made the case that the county's already congested roads are only getting worse.

In April, GMC and St. Joseph's announced a new partnership: They will jointly own and manage the new Gwinnett Cardiovascular Services, with St. Joseph's doctors lending training and support to GMC's staff.

The Certificate of Need is subject to appeal for the next 30 days. Barring any appeals, GMC says it will begin the design process in August and construction of the project in July 2009. The center is expected to open within two years.