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The Lankenau Heart Institute at Paoli Hospital gives high-risk heart patients a second chance at life

February 12, 2015 In the News

Originally published in Chester County Life magazine

At 77 years old, Clifford Lamoree of Honey Brook was at risk of losing his life to severe aortic stenosis, a condition that keeps the aortic valve (the valve between the main pumping chamber of the heart and the aorta or main artery to the body) from working properly, decreasing the flow of blood from the heart to the rest of the body. The condition often causes weakness, fatigue, and shortness of breath, and, when left untreated, can lead to heart failure and even death.

Fortunately for Clifford, some of these tell-tale signs surfaced as he arrived at Paoli Hospital for a routine visit with his cardiologist Neil Skop, MD. Clifford had been under the care of Dr. Skop since he had experienced sudden cardiac arrest during gallbladder surgery two years earlier.

“As I got out of my car, I felt a strange ‘fuzzy’ feeling in my head,” he recalled. “I chalked it up to age or being tired, but as I approached Dr. Skop’s office, I became sluggish and weak.” Clifford managed to get himself inside where he was seen immediately.

Concerned about Clifford’s current state, Dr. Skop consulted with Konstadinos Plestis, MD, system chief of Cardiothoracic and Vascular Surgery at the Lankenau Heart Institute, part of Main Line Health (MLH). Dr. Plestis, a world-renowned cardiac surgeon, had recently joined MLH in this leadership role bringing more than 20 years of cardiovascular surgical experience, specifically in aortic surgery.

Following a review of Clifford’s medical history and heart studies, and a physical examination, Dr. Plestis urgently admitted him to Paoli Hospital for management of the condition. During his hospitalization, Clifford’s health worsened, and he underwent urgent surgery to replace the valve. During the procedure, Dr. Plestis replaced the damaged valve with one made of cow tissue. Tissue valves like this are known to work extremely well, and do not require the patient to take blood-thinning medication. These replacement valves typically last from 15 to 20 years, so some patients may need to have additional valve replacement procedures later in life, which now can be done using small incisions or minimally invasively.

“It was an operation that came at the right time. My heart wasn’t as strong as it should be, and I had a leading expert ready to perform this procedure as his first surgery at Paoli. Who knows where I would be without it or without him,” said Clifford.

For patients like Clifford, explained Dr. Plestis, the chances of surviving aortic stenosis are approximately 50 percent without treatment, so this procedure offers patients not only better quality of life but also a greater chance of survival.

“Dr. Plestis told me I’d feel like a new person after the surgery,” said Clifford. “I took that with a grain of salt, but he was right. If it wasn’t for chronic back pain that severely limits my physical activity, I’d be out playing tennis.”

According to the American Heart Association, cardiovascular or heart disease is the number one cause of death, killing more than 600,000 Americans each year.

“Few heart programs in the nation can rival the comprehensive services available for patients here at the Lankenau Heart Institute,” said Dr. Plestis. “It is truly a leading-edge program dedicated to developing and providing cardiovascular treatments that save lives and restore hope.”

From prevention and diagnosis to treatment and recovery, the Lankenau Heart Institute provides expertise in caring for patients with heart conditions ranging from the most simple to the highly complex. Through its distinguished team of cardiologists, cardiovascular surgeons and subspecialists, patients benefit from the advanced treatments offered, including: coronary revascularization, minimally invasive robotic-assisted coronary artery bypass surgery, minimally invasive mitral and aortic valve surgery, transcatheter aortic valve replacement (TAVR), complex aortic surgery, and heart failure surgery. In addition, this team actively pursues new knowledge and advanced treatments through research and clinical trials.

A key member of this team is the patient navigator who provides cardiac patients and their families with a variety of personalized services designed to ensure the seamless and timely coordination of care, a consistent contact person, and a better understanding of the disease, the treatment process, and recovery plans.

“Working directly with the patient, the navigator will assess and address an individual’s ongoing needs and concerns in hopes of making their hospitalization and their transition home less stressful and more supportive,” said Maysoon Dayoub, PA, physician assistant and patient navigator, Lankenau Heart Institute.

Most recently, under the direction of Dr. Plestis, who has personally performed more than 1,000 individual aortic procedures, the Lankenau Heart Institute debuted the Aortic Wellness Program. This program is one of only two in the region and among only a handful in the nation to offer such comprehensive care and individualized treatment plans for the full spectrum of aortic problems—including the treatment of ascending, arch and thoracic-abdominal aneurysms, aortic dissections, traumatic aortic injuries, and other acute aortic syndromes including ruptures. This program was developed due to the rise in the number of people found to have aortic problems.

All patients at high risk of developing aortic problems or who require close monitoring for an already diagnosed issue are enrolled in Aortic Wellness Program to ensure that they receive the attention and ongoing specialized care they require. The goal of the program is to identify and manage these conditions in their earliest stages in order to slow the progression of disease and help patients, when possible, avoid surgery.

Alan Singmaster, 73, of Devon, was considered a complex case because he was diagnosed with both aortic stenosis and a thoracic aortic aneurism. Thoracic aortic aneurisms are weak, bulging spots on the aorta that often develop unnoticed. If they rupture, they carry a high risk of death.

“Aortic aneurisms are often called a ‘silent killer’ or ‘ticking time bomb’ because they usually develop slowly over many years without a person even knowing it’s there,” said Dr. Plestis. “As it continues to inflate, much like a balloon, it will eventually rupture, and this first symptom can be the last.”

Working in conjunction with Alan’s cardiologist Dr. Skop, Dr. Plestis monitored both conditions closely through the Aortic Wellness Program. Over time, however, tests revealed that the aneurysm had grown and the stenosis had worsened, prompting surgery. There are a variety of surgeries used to repair an aneurysm and an aortic valve. In Alan’s case, Dr. Plestis replaced both the aorta with a plastic tube and the aortic valve with one made of cow tissue.

Not long after the procedure Alan was back to his normal routine and able to do most activities without concern. “I’m feeling almost one hundred percent,” said Alan. “But one thing I can’t, or won’t do, is the ice bucket challenge.”

Alan praises the care he received by Dr. Plestis and the team at the Lankenau Heart Institute. “I’m grateful to be here today, and fortunate to have found such an amazing health care team close to home.”

Dr. Plestis believes that Lankenau Heart Institute’s excellent medical care goes beyond the latest in treatment. “My patients give me a huge responsibility by placing their lives in my hands,” he said. “I love what I do and take this responsibility very seriously. I will do what I can; every step of the way, so each individual feels secure in choosing the Lankenau Heart Institute for their care.”

The Lankenau Heart Institute team provides world-class, innovative care to patients with heart disease at every stage, close to home at four hospitals and many community cardiology sites throughout the region — including Paoli Hospital, Lankenau Medical Center, Bryn Mawr Hospital, and Riddle Hospital. To learn more about the Lankenau Heart Institute, call 1.888.225.5654 or visit mainlinehealth.org/heart.

About Lankenau Heart Institute

The Lankenau Heart Institute is Main Line Health’s premier, comprehensive cardiovascular medicine and surgery program. The Lankenau Heart Institute brings together the clinical expertise of all four Main Line Health acute care hospitals and community cardiology practices to ensure that patients receive a level of quality, service, and experience that is unprecedented in the region. Through the system-wide coordination of services, the Lankenau Heart Institute delivers preventive, diagnostic, therapeutic, and rehabilitative cardiovascular services at each of our locations including Lankenau Medical Center, Bryn Mawr Hospital, Paoli Hospital and Riddle Hospital.

Lankenau Heart Institute continues to be a pioneer in the use of beating-heart techniques and robotic-assisted procedures for coronary artery revascularization, minimally invasive and transcatheter approaches for valve repair and replacement, and complex aortic surgeries. With our growing experience and focus on minimally invasive techniques, Lankenau Heart Institute has expanded participation in clinical trials year over year. Our physicians are frequently invited to participate in clinical/medical device trials, many of these designed to facilitate minimally invasive procedures/approaches.

With a collaborative team of expert consultative cardiologists, interventional cardiologists, electrophysiologists, cardiovascular surgeons and specially trained nurses and technologists, the Lankenau Heart Institute is dedicated to managing and treating patients with heart failure, aortic disease, coronary and peripheral vascular disease, heart rhythm disorders and valve disease. Our team of cardiologists and cardiac specialists provide patients and their families with expert cardiac care, close to home.