MDNews - Central New York

The tower's design also enhances the progress of patient care. When communication is easier and transfer times are shorter, outcomes improve. Similarly, the $32 million Merola Center for Cardiac Care, which houses catheterization, electrophysiology, interventional radiology facilities, 40 patient bays and a hybrid OR, was designed both for patient comfort and for the delivery of safer, more coordinated care. ADVANCED SURGICAL TREATMENTS St. Joseph's cardiac surgical program provides a full menu of advanced treatments, including robotic and minimally invasive procedures, for valvular disease, stenosis and insufficiency, as well as aortic pathologies. "A large part of our procedures is minimally invasive," Dr. Nazem says. "For example, we go through the right side of the chest with a small incision and do mitral valve surgery, aortic valve surgery and tricuspid valve surgery. Almost all the incisions are, at most, 7 to 8 centimeters in length." Some of the surgical techniques offered at St. Joseph's, like the valve-saving "David Procedure," aren't available elsewhere in Central New York. Other surgical options offered there are " Our goal is to do what's right for the patient. Not necessarily what any one individual wants to do, but what the group thinks is best, based upon best practices and guidelines in the cardiology and cardiovascular surgery literature." — RUSSELL SILVERMAN, MD, FACC, DIRECTOR OF MEDICAL CARDIOLOGY AT ST. JOSEPH'S HEALTH St. Joseph's Health anesthesiologists work in the Electrophysiology Lab, studying the electrical activity of a patient's heart to find where an arrhythmia is coming from. St. Joseph's performs more than 1,700 electrophysiology procedures, 250 radio frequency ablations and 350 implantable cardioverter defibrillators annually. less about a specific technique than the surgeons' comfort and experience treating complex cases in a minimally invasive way. "We do triple valve replacements through a right-side, tho- racotomy, minimally invasive incision," Dr. Nazem says. "That wouldn't happen many other places." For CABG, St. Joseph's surgeons offer both robotic surgery and open bypass, including an off-pump procedure for patients at high risk for embolization or stroke. "Because St. Joseph's has the largest cardiac and critical care anesthesiology team in Central New York, it can safely offer procedures for patients who wouldn't otherwise be cleared for them," says Courtney Maxey-Jones, MD, a cardiac anesthesiologist and intensivist at St. Joseph's and its Medical Director for extracorporeal membrane oxygenation (ECMO) and mechanical support. The Institute added ECMO in 2018, to better support "the sickest of the sick," according to Dr. Maxey-Jones. She's part of a smaller team of critical care cardiac anesthesiologists that provides 24/7 evaluation of eligibility for ECMO for cardiac or respiratory etiology. The team also works closely with the cardiolo- gists and cardiac surgeons to manage day-to-day operation and then removal of mechanical support devices. "The program has really taken off," Dr. Maxey-Jones says. "It has allowed us to have some patients who either come in having an acute MI or otherwise would die of cardiogenic shock and to recover some of them and return them to independent daily living." Dr. Nazem says St. Joseph's cardiac surgeons often use Impella heart pumps independently or in combination with ECMO to support patients in heart failure. ADVANCED STRUCTURAL TECHNIQUES As the relatively young subspecialty of structural cardiology continues to evolve, St. Joseph's has stayed ahead of the field by sending its providers to receive training from high-volume providers of advanced procedures, such as TAVR and MitraClip, Nelly Kazzaz, MD 0 8❱❱❱❱❱ C O V E R S T O R Y

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