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    Technology Boosts Cardiac Care to a New Level

    By George Nevin

    Robots, 3D mapping and enhanced computer imagery may sound like tools for creating the latest movie blockbuster, but in fact they’re technologies on the forefront of advanced cardiac care.

    “Progress in cardiac care on many fronts — from new technologies to improved training and techniques — has translated into better diagnosis and treatment for individuals with heart conditions,” says Hamila Kownacki, vice president of operations.

    Valve Surgery at the End of a (Mechanical) Hand

    At CPMC, robots aren’t cute little cylinders with synthesized voices, nor are they things of the future. The da Vinci® robotic surgical system is in use today for repairing and replacing heart valves.

    Cardiothoracic surgeon Sachin Shah, M.D., FACS, explains, “Robotic surgery has recently made its way into cardiac practice, with only a few centers offering this technique.” Dr. Shah underwent 14 months of training in robotic surgery at the Cleveland Clinic, a world leader in the field, before launching CPMC’s cardiac robotic program. He’s a believer in using robotic surgery to repair or, occasionally, replace mitral valves, which allow oxygenated blood to move between heart chambers.

    Surgery with the da Vinci robot is performed through incisions about the size of a quarter, compared with incisions of up to 4 inches in traditional surgery. Through these tiny incisions, the surgeon uses the da Vinci system to insert miniaturized instruments, along with a high-definition, 3D camera to visualize the procedure.

    “There is quicker recovery, with less pain and a faster return to activities,” says Shah of the benefits of robotic cardiac surgery compared to open heart surgery.

    Electrophysiology – Taming the Runaway Heart

    Steven Hao, M.D., FACC, heads CPMC’s Electrophysiology Program, where erratic heartbeat is treated. He says that when the heart beats too fast, too slow, or erratically, serious health problems occur.

    Treatment often involves radiofrequency ablation, in which a catheter (a thin wire probe) is guided into the heart muscle to “short-circuit” rogue electrical impulses, which cause the erratic heartbeat.

    “At CPMC, our program conducts more than 550 complex ablations yearly, about 420 of them for atrial fibrillation, in which an abnormal heart rhythm originates in the top chambers of the heart, causing it to beat in a rapid, disorganized manner,” says Dr. Hao.

    “We’re proud of our accomplishments,” he explains. “Our physicians lecture internationally. As a technical expertise center, doctors come from around the world to learn how to understand and use technology. Our research is helping medical equipment companies develop better diagnostic and treatment tools.”

    Pediatric Cardiology – Diagnosing Heart Disease Before Birth

    Cardiologists who work with children, babies and the unborn are breaking down barriers to understanding the pediatric heart.

    Nikola H. Tede, M.D., FAAP, FACC director of pediatric cardiology at CPMC, says, “We are having increased success at diagnosing significant congenital heart disease before the baby leaves the hospital nursery, and even before birth.”

    Fifty years ago, congenital heart defects such as passages in the heart or valves that work improperly would have required surgery. Today, Dr. Tede says, doctors perform many of these procedures in the cardiac catheterization lab. The result — fewer children need heart surgery.

    Says Dr. Tede: “Even if we do diagnose a significant congenital heart defect in a child, we can reassure the parents that there is a good quality of life awaiting these children. That’s clear because there is a large population of adults who are living normal lives with repaired defects of the heart. It’s a medical success story on a larger front.”

    For more information on CPMC’s Heart and Vascular Center, visit cpmc.org/heart.

    CPMC Robotic Cardiac Surgery
    Mitral valve repair can be performed through a tiny incision using the da Vinci surgical system, shown here by Surgeons Glenn Egrie, M.D. (L), and Sachin Shah, M.D. (R). The robotic arms enable insertion of surgical instruments and 3D, high-definition visualization during the mitral valve procedure.


    CPMC Electrophysiology Program
    To correct the heart’s electrical system when atrial fibrillation occurs, doctors can perform radiofrequency ablation. This procedure uses a probe and catheters inserted into the heart’s atrium (left image) that provide 3D visualization and GPS-like mapping to indicate sites of ablation (right image). Doctors use an ablation catheter to target these sites and “short-circuit” the heart’s rogue electrical impulses that cause erratic heartbeat.
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