Guiding all aspects of treatment at CTA is a standardized system that covers every step of a patient's care, from a preoperative evaluation to discharge and follow-up appointments. This unique system is based on a best practices model, or evidence-based medicine. The system, which standardizes treatment and helps to ensure the best possible care for every patient, is dynamic, always under the vigilant review of CTA physicians and nurses.

• The CVICU cardiovascular recovery room where heart patients are cared for postoperatively. the CVICU is a highly specialized area of the hospital staffed by physician and nurse experts in heart care.
• Intensivists the physicians who staff the CVICU round the clock specialize in caring for postoperative heart patients. While the cardiac surgeon oversees the care of each patient and is the team leader, the intensivist is available to patients 24 hours a day with an unmatched level of expertise.
• Post-discharge care: Once the patient is discharged home, CTA remains the primary contact for that person for two weeks. Phone calls from patients during this crucial time period are usually answered directly by our physicians. At the end of the two-week period, patients return for an appointment with the surgeon, and then they are cared for in conjunction with their cardiologist and primary care physician

Surgical Expertise and Advances

Coronary Disease Minimally Invasive Techniques and Off-pump CABG

CTA physicians are leaders in minimally invasive, off-pump bypass surgery, one of the most recent advances during which surgeons perform CABG procedures without the use of the traditional heart-lung machine. One of the first in the state to perform "beating-heart surgery," or off-pump bypass, the CTA group now performs >60% of its CABG surgery "off-pump," ranking among the highest rates nationally.

Using the MIDCAB technique, off-pump surgery was combined with minimally invasive incisions in 1996 for patients with one blocked vessel. Today, with the use of advanced technology and surgical approach, CTA physicians are performing beating-heart, multivessel bypass procedures for complete revascularization with significant success. Patients avoid the side effects and risks associated with the heart-lung machine, and they generally experience a faster, smoother recovery period. This approach has been found to especially benefit high-risk patients.

Bypass Conduits

The internal mammary artery (IMA) remains the conduit(s) of choice, but in addition CTA surgeons use a new approach to bypass conduits on each and every case. When leg grafts are used, endoscopic vein harvesting is used almost exclusively. This less traumatic approach for the patient results in a faster, more comfortable recovery. The cosmetic results are superb.

Transmyocardial Revascularization

CTA surgeons are very experienced in the use of transmyocardial revascularization (TMR). With lasers, surgeons create channels through the myocardium to enhance blood flow to viable heart muscle in patients suffering from medically refractory angina and nonreconstructable coronary artery disease. This procedure is often used in combination with a CABG or angioplasty to treat an area of the heart muscle that cannot be reached using the traditional bypass or catheter procedures.

Valve Repair and Replacement

CTA surgeons offer extensive expertise in both mitral and tricuspid valve repair. Whenever feasible, valve repair is the approach of choice for disorders that require surgery. In patients with mitral valve regurgitation, the CTA success rate for valve repair procedures exceeds 90%. Intraoperative trans-esophageal echocardiography is used extensively to assess the success of repair procedures and for direct evaluation of cardiac function before and after the repair.

Thoracic Oncology

CTA surgeons offer extensive expertise in Thoracic Oncology (cancers of the Chest). CTA surgeons have trained in major cancer centers such as the Memorial Sloan Kettering Cancer Center. Patients with lung cancer, esophageal cancer, pulmonary metastasis, chest wall neoplasms, and other diseases of the chest receive world class, state of the art care by CTA. The newest advances in cancer medicine as well as minimally invasive (such as video assisted thoracoscopy) approaches to their cures are a passion of CTA.

Research

CTA surgeons have taken the lead in developing and perfecting new techniques and processes to improve patient outcomes. Current research projects include:

• Off Pump Coronary Artery Bypass Reduces Neurologic and Clinical Morbidity: A prospective Randomized Trial (accepted to be presented at the American Heart Association Asian Pacific Scientific Forum - April 25, 2002)
• Transmyocardial Revascularization and Its Effect on Quality of Life in High-Risk, End-Stage Coronary Disease Patients
• Cardiac Dispersion Cannulation and Cardiotomy-less suction may reduce cerebral microemboli- a randomized prospective trial

The content on this website is intended to provide you with a better understanding of coronary artery disease, beating heart bypass surgery and endoscopic vessel harvesting. The procedures described in this website and related links may not be appropriate for all patients. The information on this website and maintain an open dialogue with you and your an informed discussion with a physician, and is not an endorsement or recommendation of any particular physician.

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