The Beat Goes On At UPMC Passavant’s Cardiovascular Center

When a person is suffering from cardiovascular distress, time is of the utmost importance. Being able to receive fast, comprehensive care close to home can sometimes mean the difference between life and death. For residents of Pittsburgh’s northern suburbs, this care is provided by the renowned medical experts at UPMC Passavant’s Cardiovascular Center.

“At our Center,” says Teresa Petrick, president, UPMC Passavant, “patients may take advantage of a comprehensive network of cardiovascular services including basic diagnostic testing, advanced imaging, electrophysiology services, catheterization procedures, highly advanced heart surgery, state-of-the-art vascular and endovascular surgery, and cardiac rehabilitation serv-ices. These services are provided by UPMC Cardiovascular Institute cardiolo-gists, community-based cardiologists, vascular surgeons, and cardiac surgeons from the UPMC Heart, Lung, and Esophageal Surgery Institute.”

A proven center of excellence in the field of cardiac disease, UPMC Passavant has transformed from a community care hospital into a facility that provides tertiary care to patients requiring even the most complex procedures. “Residents living north of the city now have access to the same high-quality services that previously could be found only at larger, urban
hospitals, in addition to the compassionate, personalized care that they have come to expect,” says Ronald Pellegrini, MD, Chief of Adult Cardiac Surgery, UPMC Passavant.

Getting to the Heart of the Matter

There are many reasons why a person’s heart may not function to its fullest capacity, ranging from weak or damaged heart muscle to medical conditions that may
affect the heart’s valves. Patients may be experiencing problems with the electrical functioning of the heart or suffering from coronary artery disease. To determine the cause of cardiac problems, UPMC Passavant cardiologists utilize a range of diagnostic tests to help them diagnose, and then appropriately treat, each patient’s condition.

This breadth of tests includes:

• exercise stress testing and radionuclide stress testing to determine the location and extent of coronary artery disease

• multigated acquisition (MUGA) scanning to identify weak or damaged heart muscle

• electrocardiography and clinical electrophysiology evaluations to assess the electrical functioning of the heart

• echocardiography to identify conditions affecting the heart’s valves

Because time is often of the essence in the case of a cardiac event, UPMC Passavant has established a Chest Pain Center, located in the hospital’s Emergency Department, which allows emergency medicine physicians to observe and evaluate chest pain patients. Within the Center, patients are placed on portable monitors and undergo repeat lab work so that the doctors can quickly determine if the cause of the problem is a heart attack, and then take appropriate measures to treat the patient before too much damage can occur to heart tissue.

“Through interventional cardiology, doctors can locate and correct blockages in patients’ coronary arteries, as well as identify abnormalities in the heart’s valves,” says Sam Buffer, MD, Division Chairman of Cardiology, UPMC Passavant. “More than 2,000 catheterizations are performed in UPMC Passavant’s state-of-the-art laboratories each year, including procedures such as balloon angioplasty and intravascular stent placement.”

Patients suffering from heart arrhythmias — when the heart beats too quickly, too slowly, or doesn’t coordinate beats properly — are diagnosed and treated though the electrophysiology department. More than 500 electrophysiology procedures are performed at UPMC Passavant each year, with treatments ranging from medication to pacemakers to implantable cardiovascular defibrillators. Biventricular pacing devices also are available for the treatment of advanced heart failure, and radiofrequency ablation is used to treat the most therapy-resistant cases of arrhythmia.

Complex Procedures, Comprehensive Care

Since 1995, UPMC Passavant’s Open-Heart Surgery program has become home to some of the region’s most skilled surgeons who perform more than 400 procedures each year. As part of the UPMC Heart, Lung, and Esophageal Surgery Institute, UPMC Passavant’s surgeons specialize in complex procedures, such as mitral valve repair, aortic valve repair and replacement, coronary artery revascularization, and left-ventricular reconstruction. They also have special expertise with endovein harvesting, during which two small incisions are used to extract a leg vein for use in bypass grafting. By making two small incisions instead of one long incision, surgeons can help to reduce the chances of infection and complications.

In addition to these complex surgeries and surgeries to repair damage to the heart, UPMC Passavant offers a range of open-heart surgeries specifically tailored to meet patients’ needs. These include:

• routine coronary artery bypass grafting (CABG)

• emergency and repeat CABG and valve procedures

• less invasive, off-pump coronary bypass surgery

• single- and multiple-valve surgeries for adult congenital heart disorders

For patients who require a higher level of treatment and monitoring, UPMC Passavant has created specialized inpatient facilities that include intensive and critical care units, as well as a progressive cardiac care unit where specially trained staff care for patients.

Streamlined Patient Care For the Entire Range of Vascular Diseases

UPMC Passavant’s Cardiovascular Center has earned a reputation for providing state-of-the-art diagnostic and therapeutic interventions for the entire spectrum of circulatory disorders. Vascular surgeons treat patients who have peripheral vascular disease (PVD), which occurs when arteries throughout the body are blocked, as well as vein disorders, including varicose veins, chronic venous insufficiency, and thrombophlebitis — a blood clot that causes inflammation of a vein, usually in the leg. They also provide aggressive wound care and treatment for thoracic outlet
syndrome — a group of disorders that affect nerves and blood vessels in the area between the base of the neck and the armpit.

“Through UPMC Passavant’s Vascular Surgical Service and the Vascular Interventional Laboratory, patients benefit from having access to a range of state-of-the-art open and endoluminal procedures,” says Robert Rhee, MD, co-director, UPMC Passavant Cardiovascular Center. These include surgery to treat aortic aneurysms and peripheral occlusive arterial disease; aortic dissections; and direct surgical repair of all major arteries in the body. Advanced and minimally invasive options often are used, including endovascular repair of aortic and thoracic aneurysms; percutaneous angioplasty and stenting to treat peripheral arterial disease and claudication; carotid, kidney, and intestinal artery stenting; and acute treatment for arterial and venous thrombosis.

Post-operative and Preventive Care

Before and after surgery, UPMC Passavant staff work with patients to prevent heart problems from developing or reccurring. Through the Cardiac and Pulmonary Rehabilitation Program, specially trained nurses, exercise physiologists, respiratory therapists, and dietitians help patients make lifestyle changes that promote a heart-healthy way of living. A personalized diet and exercise plan helps patients to reduce cardiac risk factors such as smoking, eating a high-fat diet, and living a sedentary lifestyle.

As part of the hospital’s dedication to the prevention of cardiovascular disease, UPMC Passavant also offers frequent programs for physicians, nurses, and the community on smoking cessation, nutrition, risk factor management, and stress management.

One Patient’s Story

When John Braden, 60, was first admitted to UPMC Passavant’s Cranberry campus after feeling short of breath, he figured that he it was the result of chronic obstructive pulmonary disease, or COPD. What doctors found, however, was that Mr. Braden was suffering from severe cardiac distress, and that he needed an immediate quadruple bypass.

“It turns out that I’d had congestive heart failure for a long time,” says Mr. Braden, who often felt short of breath while traveling for his job. “By the time I went to UPMC Passavant, my heart was only operating at 20 percent.”

After his bypass, which was performed by Ronald Pellegrini, MD, Mr. Braden spent two weeks in the hospital, both in the ICU and in a private room. “The care I received was fantastic,” he says. “It was a really good experience, even considering what I went through. One of Dr. Pellegrini’s assistants, Chris Vayansky, was especially great — I’m planning on taking him out to eat someday soon.”

Mr. Braden’s wife and family also were treated well during his surgery and recovery. “They took great care of my wife, daughter, and brother while I was there, and the staff was really cooperative about answering their questions,” he says. “My wife, Jenny, also said that she was very impressed with the surgical team; they were extremely organized.

“She tells me the food was great too, but I don’t know about that,” he laughs. “After anesthesia, everything tastes like cardboard.”

Mr. Braden, who had surgery on Jan. 10, returned to his job as a manager for Fuller Environmental in March, and he continues to see his primary care physician for regular follow-up visits. “My prognosis is good,” says the Butler County resident. “They did a great job. In fact, I don’t know of any place that could have done better.

“It was funny because the doctors and staff at the hospital didn’t think I was taking my health issues seriously — they kept telling me that I was really sick,” he adds. “But I told them, ‘I have a lot of trust in you people.’ While I was at UPMC Passavant, I didn’t worry about a thing.”

Treating Congestive Heart Failure

When the heart isn’t pumping as well as it should, cells don’t get enough blood. This can result in fatigue and shortness of breath, which can make everyday activities very difficult. Currently more than five million Americans are living with heart failure, and 550,000 new cases are diagnosed each year.

“Through the UPMC Passavant Cardiovascular Center, patients with congestive heart failure, or CHF, have access to specialists from the UPMC Advanced Heart Failure Center,” says Joon Lee, MD, clinical director, UPMC Cardiovascular Institute. “As experts, we can provide rapid diagnosis and state-of-the-art treatment ranging from drug therapy to cardiac resynchronization therapy devices, defibrillators, high-risk coronary revascularization, and valve repair. Patients might also be evaluated and referred for heart transplantation or heart assist devices, as well as given the opportunity to participate in clinical trials of investigational drugs and devices.”

Heart failure specialists at the Center have special expertise in the treatment of pulmonary arterial hypertension (PAH) – a common cause of congestive heart failure. Because of the complex nature of the disease, a team of cardiologists, pulmonologists, and other health care professionals work together in providing diagnostic and therapeutic evaluation.