ADVANCED LEADERSHIP EXPERIENCED. Heart & Vascular Center. St. Mary LEADERSHIP EXPERIENCED ADVANCED EXPERIENCED ADVANCED LEADERSHIP EXPERIENCED

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1 St. Mary Heart & Vascular Center EXPERIENCED ADVANCED LEADERSHIP EXPERIENCED LEADERSHIP LEADERSHIP EXPERIENCED EXPERIENCED ADVANCED ADVANCED St. Mary Heart & Vascular Center 4

2 ADVANCED LEADERSHIP experienced EXPERIENCED EXPERIENCED LEADERSHIP ADVANCED EXPERIENCED ADVANCED leadership ADVANCED

3 Dear Fellow Physician: Experience is a prime indicator of positive outcomes. At the St. Mary Heart & Vascular Center, your patients will be in the region s most experienced hands. One of Delaware Valley s leading heart and vascular centers, St. Mary consistently is recognized nationally for the highest quality of patient care and long-term outcomes. Our cardiologists, electrophysiologists, and cardiac and vascular surgeons come from the nation s top medical schools and perform a wide range of advanced procedures. Thanks to this team of talented physicians who are supported by specialty nurses and technologists thousands of patients each year receive exceptional treatment and followup care. Further, each team member combines high-quality service with compassionate care. That s our commitment to your patients. Through our focus on communication, as well as service, you will actively participate in their care. Within 24 hours of consultation, expect a call from a specialist and, if applicable, again after the procedure or surgery. You also will receive a copy of all reports. This informative guide represents an overview of our capabilities. Should you have questions about any of our services, please call Sincerely, Richard T. Leshner, DO Chief of Cardiology, St. Mary Medical Center St. Mary Heart & Vascular Center 1

4 Diagnostic Testing With our extensive cardiovascular diagnostics and complete continuum of follow-up care, you can turn to St. Mary as the most comprehensive facility in the Delaware Valley. Diagnostic Cardiac Testing Certain indications and physical conditions require a broad range of diagnostic tests. That s what we provide. These include: 2 Calcium scoring 2 Cardiac catheterization 2 C-reactive protein blood test 2 Echo with definity contrast 2 Echocardiogram (2-D and 3-D) 2 Electrocardiogram 2 Electrophysiology studies 2 Holter monitor test 2 Nuclear stress test 2 Persantine, Dobutamine, Lexiscan, and Adenosine 2 Routine exercise stress test 2 Standard and Dobutamine stress echo 2 Tilt table testing 2 Transesophageal echocardiogram (TEE) Diagnostic Vascular Testing Our range of abdominal vascular ultrasound testing capabilities includes: 2 Aorta and iliac duplex test 2 Mesenteric duplex test 2 Renal duplex test Arterial evaluation of extremities includes: 2 Dialysis access duplex testing 2 Direct ultrasound studies 2 Indirect Doppler pressures and waveforms Venous evaluation of extremities includes: 2 D-dimer blood test 2 Doppler ultrasound exam 2 Impedance plethysmography Advanced cerebrovascular evaluation capabilities include: 2 Carotid duplex ultrasound 2 Vertebral duplex ultrasound Technology Every second counts. We meet that urgency with a 64-slice CT that generates quick and precise diagnoses of lifethreatening conditions, including cardiovascular disease, stroke, and chest pain. This technology enables physicians to create three-dimensional views of a patient s anatomy and capture images of a beating heart in as quickly as five seconds. Rapid, high-resolution images of cerebral blood vessels generated during the critical one-hour, post-stroke window enable physicians to make a quick diagnosis and determine best treatment options. Other imaging modalities we offer cardiovascular patients include: 2 3-D digital fluoroscopy 2 Cardiac and vascular ultrasound 2 Diagnostic X-rays 2 Intravenous pyelogram (IVP) 2 Nuclear medicine 2 PET/CT scanning Home Monitoring Heart team members need to be aware of critical changes, and in real time even before the patient. That s where home monitoring comes in. Our team members call the patient and, when necessary, modify care plans. This eliminates emergency situations. Home monitoring services include: 2 30-day event monitoring 2 Anticoagulation management 2 Congestive heart failure surveillance 2 Implanted device follow-up 2 Pacemaker and ICD surveillance 2 Telemonitoring surveillance See insert for scheduling information and key phone numbers. 2 St. Mary Heart & Vascular Center

5 Every second counts. We meet that urgency with a 64-slice CT that generates quick and precise diagnoses of lifethreatening conditions, including cardiovascular disease, stroke, and chest pain. This technology enables physicians to create three-dimensional views of a patient s anatomy and capture images of a beating heart in as quickly as five seconds. St. Mary Heart & Vascular Center 3

6 heart and vascular St. Mary Medical Center adds four state-of-the-art catheterization laboratories to accommodate the growing healthcare needs of our community. These labs enable physicians to view detailed three-dimensional images to non-surgically diagnose and treat cardiovascular disease and perform other image-guided procedures. Speed and precision facilitate faster, more accurate diagnosis and treatment with less radiation exposure. Our experts have performed more than 40,000 catheterization procedures, making this team one of the region s most experienced. 2 I. Interventional Cardiology St. Mary s highly recognized interventional cardiology program remains one of the busiest in the region. Lab services focus on: 2 Atherectomy 2 Atrial septal defect (ASD) closure 2 Balloon angioplasty 2 Coronary angiography 2 Coronary stent (including drug-eluting) implantation 2 Cryoplasty 2 Left ventriculogram 2 Nephrostomy tube implantation 2 Nephroureteral stenting 2 Patent foramen ovale (PFO) closure 2 Percutaneous transluminal coronary angioplasty (PTCA) 2 Peripheral diagnostic and interventional procedures 2 Permacath insertion 2 Radial access coronary angioplasty 2 Right and left heart catheterization 2 Rotational atherectomy 2 Visceral angiograms and interventions THE SPEED AND BETTER visualization of the new system and the design of the new lab area allow us to increase productivity and shorten procedure times benefits especially important to patient safety when performing emergency angioplasty to rapidly open an artery and minimize the damage caused by a heart attack. George Heyrich, MD, Medical Director, Interventional Cardiology Program 4 St. Mary Heart & Vascular Center

7 We have a talented team of experienced physicians at St. Mary Medical Center, and the availability of the most advanced technology definitely plays a role in our ability to treat the most complex cardiovascular conditions. Our patients depend on us for the very best quality of care. Richard T. Leshner, DO Chief of Cardiology Excellent Nurse Practitioner Support Our nurse practitioners provide physicians invaluable assistance in delivering optimal patient care. They screen all patients to identify issues that impact study outcome and implement treatment to reduce co-morbidity. Same-day Reports St. Mary utilizes the GE-Catalyst/Centricity System. This allows our specialists to develop procedure reports that can be faxed to referring physicians as early as the day of procedure. St. Mary Heart & Vascular Center 5

8 2 II. Vascular St. Mary leads the way with new minimally invasive endovascular approaches for treating aortic aneurysms and peripheral vascular disease. Our vascular experts adept in minimally invasive diagnostic and surgical procedures train other surgeons about the latest techniques. Our staff and facilities are second to none. Experience matters, and our surgeons, interventional radiologists, and clinical support staff have incomparable credentials. The benefits of endovascular surgery include smaller incisions, shorter hospital stays, and more rapid recovery. High-risk patients previously not eligible for traditional vascular surgery now can undergo this lifesaving endovascular surgery with less risk. Vascular tests: 2 Arteriography (angiogram) 2 CO 2 angiography 2 CT angiography 2 MR angiography 2 Venography Procedures include: 2 Abdominal aortic aneurysm repair 2 Abscess drainage 2 Aortic aneurysm surgery or repair 2 AV fistulagram 2 Carotid artery stenting 2 Carotid artery surgery (aka carotid artery endarterectomy) 2 Cholecystostomy tube placement 2 Cryoplasty 2 Deep vein thrombosis treatment with Trellis Peripheral Infusion System 2 Endoluminal laser ablation for treatment of varicose veins 2 Hemodialysis access procedures 2 Lower extremity bypass surgery 2 Mini-incisional varicectomy 2 Peripheral angioplasty and stenting 2 Renal artery repair 2 Thoracic aortic aneurysm repair 2 Uterine artery embolization 2 Vena cava filter implantation 2 Venous port insertion The latest congestive heart failure capabilities 2 For congestive heart failure and arrhythmia, St. Mary deploys a unique at-home monitoring and support service. This literally brings our expertise into a patient s home 24/7. Transmission through a phone line of real-time data from the patient to the clinician indicates critical changes in blood pressure, pulse, and blood oxygen levels. Further, homemonitoring services reduce the risk of patients experiencing cardiac events. 2 Aquapheresis Ultrafiltration Therapy removes excess fluid in the body that can occur in people with congestive heart failure. From a central intravenous line, blood is pumped into the Aquadex FlexFlow system, which filters and removes excess fluid before blood flows back to the patient. This system results in reduced length of stay, lower incidence of re-hospitalization, and fewer emergency department visits. 2 Cardiac resynchronization therapy (CRT) is used to treat the delay in heart ventricle contractions that occurs in some patients with advanced heart failure. A Biventricular Pacemaker/ ICD is the CRT pacing device surgically implanted under the skin. 6 St. Mary Heart & Vascular Center

9 Our interventional team treats deep vein thrombosis (DVT) with the FDA-approved Trellis Peripheral Infusion System, which combines guide wires, catheters, and occluding balloons to deliver clot-busting medication to the site of the DVT. The medication breaks up the blood clot and restores blood flow to the legs. We believe carotid artery stenting is an important therapy in the prevention of stroke. The minimally invasive nature of the procedure and use of local rather than general anesthesia provide a viable treatment alternative to a specific group of high-risk patients. David Drucker, MD Medical Director, Interventional Peripheral Vascular Program St. Mary Heart & Vascular Center 7

10 2 III. Electrophysiology Services Experienced team exceptional success. We boast a low event rate that we attribute to: Physician experience: Our Electrophysiology (EP) Lab performs more than 1,500 electrophysiology diagnostic and treatment procedures each year. Expert support staff: The support of highly trained and experienced cardiovascular nurses and clinicians helps us advance the science of electrophysiology. Leading-edge technology: We have remained at the forefront of new technology and procedures since opening our first EP lab in Emergent EP technology is evaluated, then embraced. St. Mary was one of the first hospitals in the region to offer radiofrequency ablation as treatment for atrial fibrillation. To diagnose and treat arrhythmias, we perform: 2 Ablations 2 Cardioversions 2 EP studies 2 Pacemaker and ICD procedures Our lab has the advanced biplane technology to diagnose and treat: 2 Bradycardia 2 Congestive heart failure (CHF) 2 Supraventricular tachycardia (SVT) 2 Ventricular fibrillation (VF) 2 Ventricular tachycardia (VT) Procedures and studies we offer include: 2 Arteriograms 2 Lead extraction procedures 2 Loop recorder implantations 2 Non-invasive programmed stimulation (NIPS) 2 Nonthoracotomy ICD implantations 2 Permanent pacemaker implantations 2 Temporary transvenous pacemaker insertion 2 Transesophageal echocardiograms (TEE) 2 Transvenous lead extraction 2 Venograms 2 IV. Open-Heart Surgery The St. Mary Heart & Vascular Center has one of the most proficient open-heart teams in the area. Since the inception of the program in 1997, our surgeons have performed thousands of procedures among the greatest number of open-heart surgeries in the region. Procedures include: 2 Aortic valve replacement 2 Coronary artery bypass grafts (primarily off-pump) 2 Lung surgery 2 Maze procedure 2 Minimally invasive ablation surgery 2 Minimally invasive valve surgery 2 Mitral valve repair/replacement 2 Peripheral vascular and aneurysm surgery 2 Repair of aortic dissection The St. Mary Heart & Vascular Center is the most preferred resource because of our: Experienced surgeons: Our cardiothoracic surgeons perform hundreds of heart surgeries a year. We were, in fact, the first hospital in Bucks County to perform open-heart surgery. Attending physician involvement: At St. Mary, attending physicians perform all open-heart surgeries, so the doctor to whom your patient is referred also will perform the surgery. Such continuity and familiarity not only improve quality, but also increase patient comfort and confidence. Dedicated Program Coordinator for cardiothoracic surgery: A specially trained and skilled critical care nurse, specializing in cardiothoracic surgery, assists in managing each surgeon s caseload. Leading-edge open-heart technology: We perform open-heart procedures in state-of-the-art operating rooms, using the most advanced technology. In response to the growing need for our cardiology services, St. Mary added a new Cardiovascular Care Unit with dedicated openheart surgery recovery and intensive cardiac care rooms. St. Mary Medical Center cardiothoracic surgeons are among the first surgeons nationwide to use the AtriClip Left Atrial Appendage Exclusion System, a newly approved device to protect patients from complications related to atrial fibrillation. This greatly reduces the risk of a stroke or heart attack occurring during the procedure. 8 St. Mary Heart & Vascular Center

11 st. mary medical center consistently receives the highest rating three stars for adult cardiac surgery from the Society of Thoracic Surgeons. This notable distinction is a reflection of the excellent and comprehensive cardiac care that our patients receive. Anil Deshpande, MD, Medical Director, Cardiac Surgery Program We have excellent success in performing complex radiofrequency ablations to treat atrial fibrillation. This is a major step forward in the management of this condition and offers patients improved control of their symptoms while potentially reducing their long-term risk of complications of the arrhythmia. scott burke, MD Medical Director, Electrophysiology Lab St. Mary Heart & Vascular Center 9

12 Inpatient Cardiovascular Care Unit (CVCU) St. Mary Medical Center consistently ranks among the top hospitals in the nation in patient satisfaction for cardiovascular services. The majority of our highly skilled nurses have attained the prestigious critical-care nurse certification from the Association of Critical-Care Nurses, meeting rigorous national requirements linked to positive outcomes. The modern Cardiovascular Care Unit (CVCU) offers dedicated open-heart recovery rooms, private rooms, overnight sleep chairs for family members, and centralized workstations for EKG monitoring, digital X-ray monitoring, and medication preparation and dispensing. We provide your patients immediate proximity to the most leading-edge resources close to home. Emergency Care The region s busiest Emergency Department, which treats more than 65,000 children and adults each year, is continually expanding to ensure the rapid assessment and treatment of patients. Our ED is equipped with the most advanced, lifesaving protocols to treat heart emergencies. And St. Mary operates the only state-accredited Regional Trauma Center in Bucks County. In our comprehensive Heart & Vascular Center, physicians locate and open blocked arteries within minutes. We work closely with EMS to have patients immediately referred to angioplasty. Our goal is to perform the procedure within 60 minutes of arrival. Our Primary Stroke Center combines a 24-hour on-call team with stroke-trained physicians from multiple specialties, including neurology, neurosurgery, radiology, and emergency medicine. The Joint Commission awarded St. Mary its Gold Seal of Approval for stroke care. In an emergency, no other area hospital is better prepared to deliver heart-saving care. State-of-the-art imaging, including our 64-slice CT; a high-volume cath lab; and our experienced team of heart and vascular specialists position us as the vanguard of heart care. St. Mary offers therapeutic hypothermia to improve survival rates and decrease the risk of brain damage in the treatment of heart attack patients. This new approach, utilizing water-filled polymer wraps, involves cooling the internal body temperature for at least 12 to 24 hours. 10 St. Mary Heart & Vascular Center

13 On average, our door-to-balloon time is 60 minutes or below, and just as important, 100 percent of our patients are treated in less than the 90-minute guideline this includes nights, weekends, and holidays a feat that only a select few hospitals can accomplish. Ronald Fields, MD Medical Director, Heart and Vascular Lab St. Mary Heart & Vascular Center 11

14 Cardiac Rehabilitation A comprehensive program with remarkable results. Our rehabilitation capabilities serve a wide range of patients from adolescent to geriatric. Each personalized program is directed by a cardiologist for patients recovering from a variety of cardiovascular diseases. We also boast an exceptionally high program-completion rate. With any post-cardiac event exercise program, dropout rates are typically high. That s not the case at St. Mary. Each year, about 90 percent of patients complete their rehabilitation sessions. Further, many continue their recovery through the maintenance phase. Designed for success The American Association of Cardiovascular and Pulmonary Rehabilitation has certified St. Mary s cardiac rehabilitation program. Why? The program has achieved a high degree of patient compliance. How? Several reasons: 2 The program is offered in three distinct phases for inpatients, outpatients, and those who need to maintain a specific exercise program to stay heart healthy. Each phase is individualized to a patient s specific needs and challenges. 2 Our experienced, motivating staff includes exercise physiologists and nurses with extensive backgrounds in cardiology and cardiac rehabilitation. They partner with physicians, patients, and families to develop the best management strategy. 2 All St. Mary rehabilitation programs are cardiologistdirected. To refer a patient to Cardiac Rehabilitation, contact a St. Mary cardiologist. See enclosed directory of St. Mary cardiovascular specialists. 12 St. Mary Heart & Vascular Center

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16 St. Mary Medical Center 1201 Langhorne-Newtown Road Langhorne, PA For physician services, call For physician referral, call