Paid Content By Peninsula Regional Medical Center – Evolution of Cardiac Surgeries

Paid Content By Peninsula Regional Medical Center – Evolution of Cardiac Surgeries


ABSOLUTELY FREE YOU HAVE NO RISK OR OBLIGATION CALL NOW THIS SEGMENT OF DELMARVA LIFE IS BROUGHT TO YOU BY PENINSULA REGIONAL MEDICAL CENTER SO HERE WE ARE JUST A FEW DAYS INTO FEBRUARY WHICH IS HEART MONTH HEART SURGERY IS SOMETHING THAT CAN CERTAINLY BE SCARY TO TALK ABOUT. TAKE IT FROM ME. K IT’S AN INTIMIDATING PROCEDURE TO SAY THE LEAST. YET ONE THAT IS IMPERATIVE IN MOST CASES. AND RESIDENTS DELMARVA AND NEED OF CARDIAC SURGERY HAVE BEEN ABLE TO HAVE OPERATIONS DONE CLOSE TO HOME SINCE THE LATE 70S AT PENINSULA REGIONAL MEDICAL CENTER. OVER THE YEARS THE PROCEDURES HAVE EVOLVED AND IMPROVED HERE NOW TO GIVE US SOME MORE INSIDE DOCTORS ACT BAKER HE’S A CARDIOTHORACIC SURGEON AT PR M C.. SO BEFORE WE GET INTO THE SURGERY ITSELF LET’S TALK A LITTLE BIT ABOUT WHAT YOU DO WHAT WHAT DOES A CARDIAC THORACIC CARDIOTHORACIC SURGEON DO. SURE. SO CARDIOTHORACIC SURGEON IS SOMEONE WHO’S BEEN TRAINED SPECIFIC TO OPERATE ON THE CHEST SO ANYTHING WITHIN THE CHEST SO PRIMARILY APPEAR M.S. WE DO HEART SURGERY AS WELL AS LUNG SURGERY SO I GUESS OVER THE YEARS THERE HAVE BEEN SOME CHANGES IN EVERYTHING. A LOT OF CHANGES SPECIFIC TO PR AND THEY HAVE BEEN DOING HEART SURGERY OPEN HEART SURGERY SINCE THE 1970S. AS YOU ALLUDED TO OVER 15000 OPERATIONS HAVE BEEN PERFORMED AT PR M.S. AND THAT’S OPEN HEART OPERATIONS RIGHT AND THEN THE EVOLUTION OF HEART SURGERY ESPECIALLY IN THE LAST EVEN FIVE TO 10 YEARS HAS TAKEN A BIG SWING TO NOW WHERE WE DO VALVE SURGERIES VIA A CATHETER WHERE WE DON’T HAVE TO OPEN UP YOUR CHEST SO CERTAIN PATIENTS IN CERTAIN CIRCUMSTANCES CAN BECOME CANDIDATES FOR WHAT WE CURRENTLY DO CALLED TABARD TAVR WHICH IS A CATHETER BASED AORTIC VALVE INSERTION DOESN’T CREDIBLE. SO WE DON’T HAVE TO OPEN YOUR CHEST IN THOSE CIRCUMSTANCES. SO WHAT’S A MULTIDISCIPLINARY TEAM AND WHAT DOES THAT APPROACH MEAN FOR THE PATIENT WELL IT’S GOOD NEWS FOR THE PATIENT AND I THINK MEDICINE HAS TAKEN A SHIFT IN RECENT YEARS BECOMING MORE MULTIDISCIPLINARY WE SEE IT BOTH WITH OUR HEART AS WELL AS OUR LUNG TEAMS AND BASICALLY MULTI DISCIPLINE REFERS TO MULTIPLE PHYSICIANS INVOLVED IN THE TREATMENT OF A PATIENT AS OPPOSED TO ONE PHYSICIAN TREATING ONE PATIENT. SO FOR EXAMPLE WITH LUNG SURGERY WE HAVE THE SURGEONS LIKE MYSELF WE HAVE THE ONCOLOGISTS OR THE CANCER DOCTORS AND EVERY WEEK WE HAVE A MEETING WHERE WE REVIEW CERTAIN CASES CERTAIN PATIENTS AND GET MULTIPLE EYES LOOKING AT IT FROM EACH SPECIALTY SO I SEE THINGS FROM A SURGICAL STANDPOINT THEY SEE THINGS FROM THE CHEMOTHERAPY TREATMENT OR THE RADIATION TREATMENT STANDPOINT AND THEN WE SIT AND WE DISCUSS AND TRY TO COME UP WITH THE BEST PLAN APPROACH FOR INDIVIDUALIZED PATIENTS FROM A HEART STANDPOINT. WE DO THE SAME THING PRIMARILY WITH THE SURGEONS THE HEART SURGEONS LIKE MYSELF AS WELL AS THE CARDIOLOGISTS AND WE HAVE MULTIPLE EYES LOOKING AT A CERTAIN CASE OR A CERTAIN PATIENT AND THEN OBVIOUSLY INVOLVING THE PATIENT IN THE DECISION MAKING PROCESS OF WHAT IS THE BEST COURSE OF ACTION. Q CAN YOU SHARE SOME OF THE MORE CUTTING EDGE PROCEDURES AND THINGS THAT YOU’RE DOING. PARENTS MOST CERTAINLY. SO WE AS I ALLUDED TO THE TAB OR THE TAVR PROCEDURE WHICH WE’VE BEEN DOING I THINK IN THE PAST FIVE SIX SEVEN YEARS AND REALLY IN THE COUNTRY IT’S ONLY BEEN AROUND YOU KNOW NO MORE THAN ABOUT EIGHT TO 10 YEARS WE’VE DONE I THINK CLOSE OR JUST OVER FIVE HUNDRED OF THEM. WELL WE DO A LITTLE OVER A HUNDRED A YEAR IS WHAT OUR KIND OF RATE IS NOW AND THIS IS THE CATHETER BASED AORTIC VALVE REPLACEMENT ALL RIGHT FOR A STUPID GUY. LET ME EXPLAIN WHAT THAT MEANS? SO IN THE HEART THERE’S THERE’S VALVES WHICH CONTROL THE BLOOD FLOW AND DIRECTION OF BLOOD FLOW. WELL THOSE VALVES CAN GET DISEASE AND ONE OF THE MOST COMMON DISEASES THAT HAPPENS ESPECIALLY IN THE ELDERLY IS WHAT’S CALLED AORTIC STENOSIS WHERE THE AORTIC VALVE OR THE LAST DOORWAY OUT OF THE HEART THE DOOR DOESN’T OPEN VERY WELL. IT BECOMES DEMOTIC AND SO SIMILAR TO HOW THE CARDIOLOGIST OPEN UP A BLOCKAGE IN A IN A CORONARY ARTERY OR IN THE ARTERY IN THE HEART. WE CAN GO IN AND OPEN UP THAT BLOCKED VALVE WITH A VERY LARGE STENT AND INSIDE THAT STENT IS A NEW VALVE THAT IMMEDIATELY TAKES OVER WORKING ONCE WE DEPLOY IT AND BEFORE YOU HAD TO DO THAT WITH OPEN CHEST SURGE CORRECT. NOT NOW NOT NOW. NOW WE CAN DO IT WITH CATHETER BASED TECHNIQUES AND IN THE RECENT YEARS THIS HAS ACTUALLY BEEN THROUGH FDA APPROVAL TO BECOME MORE AND MORE AVAILABLE TO ALL PATIENT POPULATIONS AS OPPOSED TO WHAT IT STARTED OUT WITH WITH WITH JUST HIGH RISK SURGICAL PATIENTS NOW MOST PATIENTS CAN BECOME CANDIDATES FOR THE CATHETER BASED TECHNIQUE AND THAT MEANS PATIENTS HERE ON DELMARVA CAN STAY HERE ON THE SHORE. CORRECT IN THAT AND THERE’S MANY ADVANTAGES TO THAT. THERE IS I THINK STAYING CLOSE TO HOME I THINK ONE OF THE BIGGEST THINGS WITH THAT IS YOU HAVE YOUR FAMILY AND FRIENDS NEARBY BECAUSE THE RECOVERY PROCESS IS AS IMPORTANT AS GOING THROUGH THE ACTUAL SURGERY AND HAVING FRIENDS AND FAMILY SUPPORT AND BEING CLOSE TO HOME. I THINK IT’S EXTREMELY BENEFICIAL AND YOU KNOW WE CAN WE CAN PERFORM MOST ANYTHING THAT THEY CAN DO ACROSS THE BRIDGE WHICH IS FANTASTIC? WE ARE SO PROUD TO HELP HERE AND SEE HERE ON THE SHORE. BUT TO TELL YOU THE TRUTH I REALLY DON’T WANT YOU TO HAVE TO DO THAT WHAT WOULD YOU GIVE US IS YOUR BEST ADVICE FOR US TO STAY HEART HEALTHY. I THINK THE BIGGEST THING IS BE PREVENTATIVE. LIFESTYLE MODIFICATION SO STOP SMOKING AND EAT A LITTLE BIT HEALTHIER AND THEN PART OF THAT PART OF BEING PREVENTATIVE IS MAINTAINING AND ESTABLISHING RELATIONSHIP WITH THE PRIMARY CARE PHYSICIAN WHO AT LEAST YEARLY CHECKS LAB WORK AND DOES A PHYSICAL EXAM AND MAKE SURE YOU ARE LEADING A HEALTHY LIFESTYLE AND UNFORTUNATELY IN WELL NOT JUST IN DELMARVA BUT IN THE US AND IN THE WORLD PEOPLE DON’T WE’RE NOT VERY GOOD AT PREVENTATIVE MEDICINE WE SEE A LOT OF PATIENTS WHO HAVEN’T SEEN A DOCTOR IN 10 15 YEARS. THEIR MEDICATIONS THEY MAY NOT BE TAKING ANY OR THEY’RE TAKING THE WRONG DOSES OR THEY’RE TAKING TOO MANY OR WHATEVER. SO BEING PREVENTATIVE LIFESTYLE MODIFICATION AS WELL AS FOLLOWING UP AND DOING ESTABLISHED CARE WITH A PRIMARY CARE PHYSICIAN ALL RIGHT GOOD ADVICE DR. FACT BAKER ON MUCH