Cardiovascular Surgery

The cardiovascular and thoracic surgeons at the Main Line Health Heart Center at Lankenau, Bryn Mawr, and Paoli Hospitals perform greater than 1,000 surgeries annually. In 2007, 756 heart surgery cases were performed, making the Heart Center one of the largest programs in the Philadelphia, Pennsylvania, region.

Our Heart Center’s specialty team of experienced professionals includes board-certified surgeons, physician assistants, nurse practitioners, cardiac nurses, anesthesiologists, and surgical technicians. We continually monitor our outcomes, allowing us to be active in performance improvement. This process, in many cases, results in exceptional outcomes exceeding the national average.

Our comprehensive services include:

• Coronary Artery Bypass Grafting (CABG) Surgery—off-pump (beating heart) and traditional (on-pump) — at Bryn Mawr, Lankenau, and Paoli Hospitals
• Collaborative treatment (hybrid procedures that combine surgery and stent intervention) for coronary artery disease, offering patients the least invasive method to treat their disease
• Three daVinci robots and the latest version of the daVinci® S High Definition Surgical System Robot at Lankenau, which offers cutting-edge technology for minimally invasive cardiac surgeries, including CABG and valves
• Keyhole surgery, which eliminates the traditional bone-breaking, long chest incision, offers less pain and reduces bleeding, while maintaining patient strength for a smoother, and often faster return to normal activities
• Mitral valve repair, our preferred method of treatment for mitral valve disease, although mitral valve replacements are also performed
• Aortic valve replacements for congenital defects, bicuspid leaflets, or adult acquired disease; aortic root replacements are also performed, if required.
• Concomitant procedures including CABG and valve, CABG with other complex procedures, or surgery on multiple valves during the same operation, including that on the tricuspid valve
• Ablation, surgical treatment for atrial fibrillation
• Repair of congenital or adult-acquired anomalies, such as Atrial Septal Defect and Ventricular Septal Defect.
• Transmyocardial revascularization (TMR), with or without CABG. TMR is used for areas of the heart that cannot be bypassed or revascularized surgically; a laser is used to create small channels through the heart to supplement myocardial oxygenation.
• Aortic root wrap for treatment of aortic root dilation
• Ventricular remodeling
• Ventricular assist device (VAD) therapy for heart failure
• Carotid endarterectomy for carotid artery disease
• Plus, a wide array of lung surgery procedures, both open and thorascopic

Innovation

Main Line Health Heart Center heart surgeons are national and international innovators:

• More than 90% of our CABGs are done off-pump, compared to the national average of 19.6%. Patient benefits of heart surgery without cardiopulmonary bypass include quicker recovery, fewer cognitive and neurological consequences, shorter hospital stays, and reduced need for blood transfusion.
• Cardiac Surgery Team Initiatives lead to a more satisfactory and quicker postoperative recovery. These include:
  • Extubation while in the OR
  • Aggressive pain management
  • Early ambulation, out of bed within 4 hours of surgery
  • Blood management and conservation program to reduce the need for transfusion
  • Deep vein thrombosis prevention
  • Reduction in infections and other hospital-acquired complications including falls
  • Stroke reduction initiatives
• Our heart surgeons use cerebral oximetry to monitor cerebral oxygen saturation, contributing to our reduced incidence of stroke in the isolated CABG population. Our rate of postoperative stroke in 2007 was 0.3%, well below that of the STS National Adult Cardiac Surgery Data benchmark of 1.1%.
• Endoscopic harvesting of radial artery and/or saphenous vein is the standard of care for coronary artery bypass surgery.
• Main Line Health Heart Center is pleased to recognize that we have one of the nation’s busiest robotic revascularization surgeons — the busiest on the east coast.
• We offer mitral valve repair, which generally has greater longevity in comparison to valve replacement and eliminates the need for life-long blood thinners. Greater than 90% of isolated mitral valve repairs are performed using a minimally invasive technique. We are a national training center for minimally invasive mitral valve repair using Port Access technology.
• We pioneered the use of "stentless" tissue aortic valvesm, which use the patient’s own aortic wall for support, leaving more space for improved blood flow. Data suggest degenerative effects are slowed as a result of this design.
• Heart Center surgeons were among the first in the region to use the aortic wrap techniques for treatment of aortic root dilatation.
• Our ventricular assist and heart transplant surgeon led the team that implanted the world’s fifth implantable artificial heart and is recognized as a leading authority on mechanical circulatory assist devices.

Experienced patient care

• Our cardiac surgeons jointly have over 75 years operating experience.
• Our heart surgeons are nationally recognized, are noted lecturers and distinguished authors; they have published numerous papers on cardiac surgery in several peer-reviewed scientific journals. They have spoken at conferences to both clinical and consumer audiences on the issues that affect men and women with heart disease and are frequently quoted in alternative media, newspapers, and magazines including Newsweek.
• Our heart surgeons work closely with the patient’s cardiologist and primary care physician during treatment planning and follow-up.
• Patient lifestyles and activities are discussed at length to determine which type of valve is best suited for each individual patient — Stented or Stentless, Mechanical, Homograft, or Bioprosthetic.
• The excellent care continues post-operatively in our Cardiothoracic Intensive Care and Progressive Care telemetry units. Our nursing staff continues caring for patients after discharge, with follow-up phone calls to check that patients are taking their medications, checking their weight daily, addressing any needs or questions they may have at home, and confirming they have made their appointments with surgeons and cardiologists.
• Accredited cardiac rehabilitation begins in the hospital and continues on an outpatient basis.
• Our doctors are also involved with research that brings the newest treatments and innovations to our patients.

Quality assurance

We monitor our own results on an ongoing basis, and compare our statistics to the national benchmark of the Society of Thoracic Surgeons. We maintain a concurrent database, which is then “harvested” to the STS National Database. This permits us to develop tracking tools, allowing refinement to our own methods, and continually improve our patient care and delivery system.

New hope for heart failure patients

The Heart Failure Program, based at Lankenau Medical Center, brings together a team of nationally respected experts to provide aggressive, individualized treatment for patients with all degrees of heart failure. When required, ventricular assist devices can be used either as a bridge to transplant or a bridge to recovery. Patients requiring heart transplantation are evaluated and cared for by a team of specially trained medical and support professionals.

Advancements in cardiac research

Main Line Health Heart Center physicians stay at the forefront of medical research by participating in clinical research trials. Today, we are actively involved in 25 clinical research trials, including multiple heart valve devices, valve repair techniques and treatment of atrial arrhythmias. Because of our involvement, patients often gain quicker access to the newest treatments or procedures available. In addition, the Heart Center at Lankenau Medical Center teaches tomorrow’s physicians through accredited fellowship programs in cardiology, interventional cardiology and electrophysiology.