Team Approach to Heart and Vascular Care
Team Approach to Heart and Vascular Care Benefits Patients
From a Patient
James Layton of Quakertown
praises his heart valve replace-
ment procedure at St. Luke's
and the multidisciplinary team
who cared for him.
St. Luke's Heart & Vascular Center is taking a team approach to cardiovascular care, helping patients benefit from increased physician collaboration that yields the best possible treatment outcomes.
Physician teamwork is key to the treatment and management of cardiovascular concerns. At St. Luke's Heart & Vascular Center, patients benefit from seeing a team of physicians from separate specialties of cardiology, including cardiologists, electrophysiologists, cardiac surgeons, vascular surgeons and interventional radiologists, under one roof. This multidisciplinary approach to care enhances physician communication, allowing patients to benefit from improved diagnosis, treatment and management of cardiovascular disease.
“Each physician at St. Luke's Heart & Vascular Center has his or her own expertise,” says Ellen A. Redstone, MD, interventional radiologist. “By bringing these specialties together, we are able to provide the most up-to-date medical care and can collaborate to ensure we identify a solution that will provide the best possible outcome.”
“This multidisciplinary approach allows patients to benefit from an efficient and comprehensive evaluation and treatment plan that is derived from discussion among multiple specialists,” adds Stephen A. Olenchock, DO, Chief of Cardiovascular Surgery at St. Luke's Hospital & Health Network. “For example, if a patient presents with an aortic aneurysm, he or she can see an interventional radiologist, vascular surgeon and cardiac surgeon who will all work together to provide the most up-to-date and appropriate treatment plan. The same is true for cardiac patients suffering from structural heart disease, as they have the benefit of seeing a cardiologist for medical management and an interventional radiologist for diagnostic testing, in the same location.”
Minimally Invasive Surgical Services
Through St. Luke's Heart & Vascular Center, patients benefit from a full complement of invasive and noninvasive cardiac services.
“This allows patients to receive the most effective minimally invasive care possible,” says James D. Balshi, MD, Medical Director of the Vascular Center at St. Luke's Hospital & Health Network. “When minimally invasive care is not possible, patients receive the most effective surgical treatment for their disease process.”
A full array of cardiac and peripheral vascular disease treatments are available, with the exception of heart transplantation. This includes minimally invasive surgery for the correction of thoracic and abdominal aortic aneurysms, renal artery reconstruction, carotid endarterectomy and carotid stenting.
“At St. Luke's Heart & Vascular Center, we are proud to offer patients the latest minimally invasive techniques for vascular surgery,” says Dr. Olenchock. “Outcomes achieved by patients in vascular surgery, interventional radiology, cardiology and cardiac surgery are very successful. Through this program, patients benefit from the highest level of cardiovascular care available in our region.”
Minimally invasive reconstruction of aortic aneurysms provides patients with an option other than an extensive surgery, which may require seven to 10 days in the hospital. Through the utilization of minimally invasive techniques, both abdominal and thoracic aortic aneurysms can be treated, depending on the aneurysm's location within the body. Minimally invasive mitral valve replacement and repair is also available to patients through St. Luke's Heart & Vascular Center.
Previously, aortic aneurysm repair involved an invasive, open procedure. Patients generally stayed in the hospital for one week following surgery — with one to two days spent in the Intensive Care Unit — and experienced a lengthy recovery.
During a minimally invasive aortic aneurysm repair, physicians are able to perform the procedure using an endovascular approach that involves placing a catheter through the femoral artery in the groin. Physicians are then able to repair the weakened portion of the aorta without necessitating an open incision, which allows patients to benefit from shorter recovery periods and less pain, reduced bleeding and a lower risk of infection after surgery.
Minimally invasive mitral valve surgery can be performed in a similar fashion using endovascular techniques. With these techniques, physicians at St. Luke's Heart & Vascular Center have great success in repairing the mitral valve, which prevents the need for valve replacement and greatly aids patients' recoveries in many cases.
Emergency vascular repair utilizing endografts is also becoming more commonly used through St. Luke's Heart & Vascular Center. Previously, patients would be taken straight to the operating room if they were suffering from an aortic transection or chest trauma. Embolization of the arteries, which is used to prevent bleeding in internal organs — including the spleen or liver — in cases of severe pelvic trauma, is also performed by St. Luke's Heart & Vascular Center's team of experienced interventional radiologists.
“In the past, vascular repair of aortic transection using an endograft was an elective procedure,” says Dr. Redstone. “However, through our continually evolving techniques and desire to provide patients with the most up-to-date care possible, we have been able to perform minimally invasive procedures in emergency situations as well.”
For patients suffering from deep vein thrombosis, pharmacomechanical thrombolysis is available. This procedure allows blood clots in the legs to be destroyed and removed in a minimally invasive fashion, which helps to improve vein health after the procedure.
“Many patients with deep vein thrombosis are candidates for pharmacomechanical thrombolysis,” says Dr. Balshi. “This approach has a profoundly positive effect on the overall health of the veins in a patient's legs even as many as 20 years later.”
Aiding Patient Care Through the Development of New Techniques
St. Luke's Heart & Vascular Center has an emphasis on research as well as clinical care. Currently, staff members are involved in several clinical trials in the areas of aortic aneurysm repair and carotid stenting.
To help measure the success of minimally invasive aortic aneurysm repair, researchers are participating in the CardioMEMS EndoSure Sensor for Long-Term Follow-up of Endovascular Aneurysm Repair (PRICELESS) trial. By placing the CardioMEMS EndoSure Sensor — an implantable pressure sensor — into the patient's aorta, physicians are able to monitor the success of endovascular aortic aneurysm repair, which helps to limit the number of CT scans generally required for long-term monitoring.
Leaders in carotid stenting, physicians at St. Luke's Hospital & Health Network are also participating in the world-wide Stenting and Angioplasty With Protection in Patients with High Risk for Endarterectomy (SAPPHIRE) trial. Using the Cordis PRECISE Nitinol Stent Systems and the Cordis ANGIOGUARD XP Emboli Capture Guidewire, physicians are able to monitor outcomes for a new carotid stenting procedure that will help define who will benefit most from the use of this technology. The objective of the trial is to analyze the effectiveness of stenting with distal protection for the treatment of obstructive carotid artery disease.
St. Luke's Hospital & Health Network is also an international show site for General Electric Health Care and was instrumental in developing the GE Innova 4100 Peripheral Imaging System. This state-of-the-art technology is utilized for peripheral arterial and venous imaging.
Highest Level of Care Possible
“We strive to provide patients throughout the Lehigh Valley with the highest level of care possible from both a quality and outcomes standpoint,” says Raymond A. Durkin, MD, Chief of Cardiology for St. Luke's Hospital & Health Network. “By providing patients with the latest techniques and technologies in a convenient center where they can see all of their health care providers in one setting, patients receive exceptional care in a comfortable, patient-centered atmosphere.”