MDNews - Mid Hudson

COVER FEATURE The operating room staff at Good Samaritan Regional Medical Center: Noel Guneratne, S.T.; Zolita Sansiveri, R.N.; Mark Nikollaj, perioperative assistant; Patricia Bailey, R.N.; B. Biaz, M.D.; and Howard Rodriguez, S.T. TH E C AR DIAC TE AM AT GOO D SAMARITAN R EG IO NAL M EDI C AL C ENTER GOOD SAMARITAN REGIONAL Medical Center has assembled an expert team of multidisci- plinary cardiac physicians to provide care in the lower Hudson Valley. + Edward F. Lundy, M.D., Ph.D., Chief of Cardiac Surgery + Rawn Salenger, M.D., cardiothoracic surgeon, Director, Center for Valve Surgery + Cary L. Hirsch, M.D., FACC, Director of the Cardiac Catheterization Lab and Medical Director of Clinical Trials + Richard Cantor, M.D., Director of Diagnostic Testing + Michael Inner���eld, M.D., Co-Director of Peripheral Intervention + Lance Kovar, M.D., Director of Cardiac Emergency and Interventions + Andrew Shih, M.D., Director of Inpatient Care regurgitation ��� a condition that occurs when the mitral valve does not close correctly. This causes a backward ���ow of blood into the atrium from the ventricle, leading to decreased blood ���ow to the rest of the body. Mitral valve regurgitation may be contributed to by a heart attack, coronary artery disease, heart valve infection, ���broelastic de���ciency or rheumatic heart disease. Surgical intervention is not always necessary. However, if the regurgitation becomes signi���cant, the Center for Valve Surgery can meet with patients and evaluate the need for surgery. If Dr. Salenger or Dr. Lundy concludes the condition 8 | Mid Hudson MD NEWS I MDNEWS.COM is severe, surgery can be scheduled and follow-up care coordinated with referring physicians. Restoring Mitral Valve Competence and Quality of Life Dr. Salenger notes that mitral valve repair demonstrates the bene���ts achieved through surgical intervention. It is common for patients with advanced degrees of mitral valve regurgitation to see huge de���cits in quality of life, such as fatigue, loss of energy and shortness of breath. According to Dr. Salenger, restoring mitral valve functionality can eliminate most, if not all, of these symptoms. Additionally, patients who have had chronic mitral valve regurgitation may develop a dilated heart with decreased function, which can lead to heart failure. Dr. Salenger notes that surgical intervention may help to partially or completely reverse heart dilation, as well. By following a philosophy of preserving as much native valve tissue as possible, surgeons at the Center for Valve Surgery aim to repair the mitral valve, not replace it. Doing so, says Dr. Salenger, restores function, which leads to an enhanced quality of life and normal life expectancy curve. Patients also bene���t from retaining their own valve instead of having an artificial replacement. When arti���cial valve replacement proves necessary, surgeons strive to preserve as much of the valve-supporting structure as possible, maintaining as much natural continuity between the heart muscle and the new valve as possible. In the operating room, the heart is opened while the patient���s circulation is maintained by a specialized heart-lung machine. The patient���s mitral valve is carefully analyzed. This information is synthesized together with functional data obtained by transesophageal echocardiography performed in the operating room before opening the patient���s chest. By integrating anatomic and functional information about the valve, Dr. Salenger is able to create a plan for repairing the valve and restoring proper function. Dr. Salenger states that mitral valve repair is one of the most gratifying operations he performs. ���One of the things I love about mitral valve surgery is that there is a certain amount of art that goes into restoring a valve,��� he says. ���When you take a leaky valve and rebuild it and see it working perfectly, it���s beautiful, and you know you have really helped that patient. By employing techniques that allow for less resection of native valvular tissue and greater surface area for valve coaptation (a zone within the valve which affects mitral valve function), we are able to produce a long-lasting repair that will ultimately lead to better heart function.���

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