THERE ARE FIVE MILLION PEOPLE in the United States suffering from chronic heart failure, with about 550,000 diagnosed each year. Using state-of-the-art advances in cardiac care, New Jersey’s top hospitals are saving lives and improving the quality of life for survivors and their families.
My patient Patricia Alberque has a heart rhythm disorder called atrial fibrillation, which puts her at risk for blood clots that can lead to stroke. Mrs. Alberque experienced sudden severe bleeding, a dangerous side effect from a blood-thinning medication which was prescribed to prevent blood clots. In the past, she would have had two options: either stop taking the medication but remain at an increased risk of stroke, or continue to take the medication and risk another severe bleeding episode. She decided to try an alternative approach. Mrs. Alberque’s cardiologist, Dr. Dennis Katechis, and I recommended a new procedure in which an FDA-approved device, The Watchman, is permanently implanted in the heart to prevent blood clots from exiting and entering the bloodstream. We successfully performed the procedure, and a month later, Mrs. Alberque is feeling great. This device will allow her to remain off blood thinning medications, thereby lowering her risk of bleeding, while still reducing her risk for stroke.
A groundbreaking technology offered at HackensackUMC called Transcatheter Aortic Valve Replacement (TAVR) gave 88-year-old, Kenneth Donoghue a second chance at life. He had shortness of breath, high blood pressure, and no other treatments available to him to alleviate his aortic stenosis. Without treatment, he would have been sent home in hospice care. His physician, Dr. Thomas Cocke gave him hope with the TAVR procedure, a revolutionary new way to replace an aortic valve without the use of a heart lung machine or open-heart surgery. During the procedure in HackensackUMC’s new state-of-the-art Hybrid Operating Room, the physician inserts a valve through a small cut in the patient’s leg. The valve is advanced on a balloon catheter placed in the upper leg and advanced along the arteries to the heart and through the native aortic valve. The balloon is then expanded leaving the new aortic valve in place. With our rapidly aging population, a growing number of patients suffer from severe aortic stenosis, and we have the ability to do something to help them lead a more productive lifestyle in this phase of their life. Six months after the procedure, Kenneth walks three miles a day and actively volunteers in his community.
Holy Name Medical Center is one of the first hospitals in New Jersey to use a new, miniaturized wireless monitoring sensor to manage heart failure. We are implanting the CardioMEMS heart failure monitoring device into the pulmonary artery of congestive heart failure patients to better treat and improve their outcomes. Heart failure occurs when the heart is unable to pump enough blood to meet the body’s demands. Heart failure patients have frequent hospitalizations, a reduced quality of life and a higher risk of death. Prior to this device we would rely on symptoms such as shortness of breath or weight gain to detect worsening heart failure. The new system directly measures pulmonary artery pressure—an indicator that occurs earlier than weight or blood pressure changes—and allows us to actually treat heart failure before a patient is symptomatic or requires hospitalization. This technologically sophisticated device automatically and remotely transmits critical information about the patient’s heart failure status from the patient’s home, eliminating the need for additional doctor’s office visits. On a larger scope, CardioMEMS allows our clinical staff to detect a patient’s worsening heart failure sooner, allowing for expedited adjustments to medications, which will lessen the recurrence of symptoms and reduce hospitalization.
Eight weeks to the day of his quintuple cardiac bypass surgery at The Valley Hospital, Steven Weissman fulfilled his promise to his daughter, Marisa: to walk her down the aisle on her wedding day. Later that night, Steven and Marisa danced the traditional father-daughter first dance.
“Right after surgery, I told him, ‘I need you to dance with me,’” she laughs. “Of course, I cried during the actual dance. We might never have had that important moment if it wasn’t for his phenomenal doctors, nurses and staff at Valley.”
Superior care and high-quality outcomes are just two of the hallmarks of Valley’s cardiac program that led Cleveland Clinic—the No. 1 heart hospital in the country—to choose Valley as its regional cardiovascular affiliate. After experiencing chest pains, Steven, 70, was taken by ambulance to Valley where diagnostic tests showed five blockages in his coronary arteries.
“To hear your father needs heart surgery is very traumatic,” says Marisa, a third-grade teacher in Mendham. “But Dr. Zapolanski told us very calmly that this is what Dad needed and that everyone at Valley would take wonderful care of him.”
Steven attended Valley’s cardiac rehabilitation program to strengthen his heart and improve his fitness, and is happy to be back at work with his son Micah and wife Rona in the family book distribution business.
By chilling the whole body, therapeutic hypothermia can slow brain damage or even prevent it from happening. At Trinitas Regional Medical Center, appropriately identified cardiac patients benefit from a rapid interdisciplinary response that dramatically increases the rate of positive patient outcomes. Known as “Code Frosty,” this protocol is used in the first few minutes following a cardiac arrest. One such case involved an elderly patient who experienced cardiac arrest and received CPR from our paramedics. En route to our ED, the paramedics treated him with icepacks and cooled IV solution to lower his body temperature to 91 degrees. In the ED, he was wrapped in a specially designed vest and leg coverings where he continued to undergo the bodycooling process. While under sedation in the ICU in the next 24 hours, he remained in a cooling mode while his normal body functions were monitored. His body temperature was warmed gradually and finally returned to normal level. Thanks to Code Frosty, the patient received a steady supply of oxygen from his heart to his brain and, after a few days of care, he was able to leave the hospital and rejoin his very happy family.