Despite substantial improvements in the treatment of cardiovascular disease over the past 25 years, heart disease is still the leading killer of both men and women — accounting for one in every four deaths, according to the CDC.
In an ongoing effort to make a difference in the communities it serves, Akron General Heart & Vascular Center has been focused on expanding and advancing its services. In the last several months, new physicians, a new hybrid operating room (OR) and new technology-based treatments have been introduced to help in this endeavor.
“We’ve really been working on expanding our staff over the last year and a half,” says Dennis Wright, MD, Akron General’s Chief of Vascular Surgery and Executive Medical Director of the Heart & Vascular Center. “We added Dr. Shyam Bhakta who does interventional cardiology; Dr. Anubhav Garg, a cardiologist who has expertise in cardiomyopathy and structural heart disease; Dr. Jill Zink, a vascular surgeon with expertise in minimally invasive treatment of complex aneurysms; and Dr. Joseph Lahorra, a cardiothoracic surgeon who specializes in coronary artery bypass, valve repair and replacement, and lung resection.”
A Cleveland Clinic cardiothoracic surgeon, Joseph Lahorra, MD, is now performing surgery as part of the comprehensive team at Akron General Heart & Vascular Center. Dr. Lahorra specializes in coronary artery bypass, valve repair and replacement, and lung resection, with a focus on minimally invasive approaches.
Dr. Lahorra has been a Cleveland Clinic cardiothoracic surgeon for over 15 years. He recently joined Akron General’s veteran cardiothoracic surgeon Dr. Patrick Stocker. Together, they intend to expand minimally invasive heart surgery options in Summit County. Dr. Zink is doing the same with vascular surgery.
“She’s brought some advanced techniques taking some of our minimally invasive procedures and almost turning them into percutaneous procedures with incisions that are barely bigger than a centimeter,” says Dr. Wright.
New Hybrid OR
In June 2014, Dr. Wright was one of the first to utilize Akron General’s new $2 million hybrid OR. Nine months later, over 200 procedures have been performed there.
“A hybrid operating room combines sophisticated imaging systems of a catheter-based interventional lab with the specialized equipment and sterility standards of a traditional operating room,” he explains.
The advantages are many. The flexibility of the OR accommodates both surgical and endovascular procedures — sometimes at the same time — thus reducing a patient’s OR time. The hybrid OR’s advanced imaging technology allows for real-time images at the operating table to be integrated with pre-surgical images. And, because the hybrid OR is a fully functional OR, an endovascular procedure can immediately be converted into an open procedure if needed.
The result is a highly efficient, optimal environment for patients in need of stent-graft placement to repair aneurysms in the chest and abdomen, treatment for peripheral artery disease, catheter-based heart valve repair and implantation, and ICD lead removal.
“Our hybrid OR also has everything that’s needed for transcatheter aortic valve replacement (TAVR) surgery,” says Dr. Wright. “Part of what we have at our disposal is the resources of the best and the most experienced heart program in the country, and that’s Cleveland Clinic. So we’re looking to the Clinic for guidance in initiating a TAVR program. Dr. Lahorra, of course, will be instrumental in this.”
New Technology-based Treatments
In the meantime, two new treatments have been added to Akron General’s heart care options: a subcutaneous implantable cardioverter-defibrillator (S-ICD) to monitor the heart and treat for sudden cardiac arrest, and drug-coated balloon (DCB) percutaneous transluminal angioplasty (PTA) to open narrowed or blocked arteries in the leg above the knee.
The S-ICD is a battery-powered device implanted below the left armpit just under the skin. Unlike traditional ICDs and their leads, the S-ICD leaves the heart and blood vessels untouched, so there’s less risk of infection and less risk if the device needs to be removed.
The S-ICD is a battery-powered device — smaller than a deck of cards — implanted below the left armpit just under the skin. Unlike traditional ICDs and their leads, the S-ICD leaves the heart and blood vessels untouched, so there’s less risk of infection and less risk if the device needs to be removed.
Manufactured by Boston Scientific, the S-ICD is the first of its kind in the world. It received FDA approval in September 2012. Jeffery Courson, DO, implanted his first S-ICD at Akron General in December 2014.
“The S-ICD offers potential advantages to individuals with compromised vasculature or increased risk for infection,” he said. “It may also offer some benefits to younger and healthier patients by avoiding some of the long-term risks of leads placed within the heart.”
DCB PTA was FDA-approved in June 2014 for use in the femoropopliteal arteries. Dr. Wright performed his first case in January at Akron General.
“Instead of just doing an angioplasty, you inflate the balloon and leave it opposed to the surface of the vessel for 30–60 seconds to dispense the drug Paclitaxel from the surface of the balloon into the wall of the vessel,” he explains. “This is primarily aimed at the superficial femoral artery because we do tend to see a significant number of restenosis there. And stents do not tend to work quite as well in the superficial femoral artery as in other locations, such as the coronary arteries.”
Dr. Wright points out that preliminary studies have indicated drug-eluding balloons have better results than non-drug-eluding balloons, and that they may be better than stents alone.
“It’s early data, and time will tell,” he says. “Right now, we’re just excited to be the first hospital in Akron to offer this and other innovative treatment options to our patients.”
For more information about Akron General Heart & Vascular Center, visit akrongeneral.org/heart. To refer a patient, call 1-800-HEART50 (1-800-432-7850).