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"For any program to be successful, you must have a good relationship between cardiologists and the cardiothoracic surgery team, which we've maintained at Vassar Brothers medical Center and with cardiology groups in the area. That's what has sustained our program's success." — Mohan r. Sarabu, MD, FaCS, FaCC, Chief of Cardiothoracic Surgery at vassar Brothers Medical Center Daniel o'Dea, MD, FaCC, Chief of Cardiology, and Jennifer thietje, rn, Unit Leader, Cardio-thoracic Step Down Unit, review a patient's chart with the patient before discharge. ambulance — EKG electrodes attached to the patient send this information to the hospital," says Dr. O'Dea. "Patients may be 15 to 20 minutes away, but we're receiving this information. While the ambulance is transporting the patient to us, the cardiac team responsible for opening the artery and restoring blood to the heart is already assembling at the hospital. When the patient arrives, the team is ready to proceed." This technology reduces the time from when the patient enters the doors of the hospital to when he or she receives balloon angioplasty by an average of 15 minutes, making the average door-to-ba lloon time 60 minutes. (The national standard per methods, which require electrophysiologists to stand bedside for the entirety of the procedure and direct the catheter under X-ray guidance, magnetic navigation provides a less grueling procedure that exposes patients to less radiation. "Magnetic technology requires taking one electrocardiographic image that we match up to the magnetic system, eliminating the need for X-ray guidance to move catheters from place to place in the body," Dr. O'Dea explains. "Electrophysiologists perform the procedure while sitting at a console, and the procedure is quicker and more precise. It is also safer because the imaging provides 3-D visualization as opposed to 2-D X-rays, reducing the risk of untoward events." the American Heart Association is 90 minutes or less.) Dr. O'Dea notes this shortened time reduces the incidence of heart failure. Guided by magnets Within Vassar Brothers Medical Center's walls, electrophysiologists take advantage of leading-edge technology to perform ablation and other catheterization procedures. Magnetic navigational tools provide electrophysiologists more precise methods for directing catheters to ablation focal points to treat abnormal electrical pathways and manipulating catheters through arteries, according to Dr. O'Dea. Compared to traditional L–r: Dr. Sarabu; geraldine Kenny, nP; and Mariyka Kostova, Pa, review X-rays and patient charts. Collaboration Across the Continuum When patients require more intensive intervention, Dr. O'Dea explains, collaboration between cardiologists and cardiothoracic surgeons provides complete care for the entire disease process. "Cardiologists work in concert with cardiac surgeons to ensure patients receive the best care before and after surgery," Dr. O'Dea says. "Often, surgery alleviates the problem, but doesn't cure it, and the underlying disease is still present — surgeons don't remove diseased arteries; they work around them. For many cardiac conditions, patients require long-term care to make certain the disease doesn't progress. mDNeWS.Com ■ MD News Mid Hudson |7