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Q&A: Cardiovascular Health
How is Suburban Hospital's cardiac surgery program different from others in the area?
We provide high-quality, accessible and cost-effective surgery and therapeutic angioplasty, while fulfilling an important role in research and training. In addition to the surgical component, the program involves research of national significance, bringing the clinical and scientific excellence of National Institutes of Health (NIH) and Hopkins to the general population. It will also provide training for a new generation of cardiac surgeons and cardiologists.
What other cardiovascular services does Suburban Hospital offer?
Suburban Hospital's comprehensive cardiac services already include emergency angioplasty for heart attack victims, a cardiac care unit, three state-of-the-art catheterization laboratories, research programs in stroke and cardiac diagnosis in collaboration with the NIH, a cardiac rehabilitation center, an active community outreach and education program and the innovative HeartWell program targeted to those at high risk of illness due to cardiovascular disease. One of the newest and most innovative pieces of cardiac diagnostic technology is the new 64-slice GE LightSpeed Volume CT scanner that is able to produce amazingly vivid 3-D images of the entire body in 10 seconds. Suburban Hospital is one of the first hospitals with this technology in the Washington, D.C. area.
How does the CT scanner benefit patients with cardiovascular disease?
Though computerized tomography (CT) coronary angiography has been available since the late 1990s, the clinical practicality of scanning an organ in motion has remained a significant challenge. Now that the new technology can deliver a comprehensive view of the heart and surrounding vessels with heightened resolution within five seconds, CT coronary angiography shows great promise in being able to noninvasively diagnose clinically significant coronary disease. In addition, CT will likely be used in partnership with the NIH's existing cardiac magnetic resonance imaging (MRI) research program at Suburban Hospital. This will help determine the effectiveness of different imaging modalities for diagnosing life-threatening clinical conditions in chest-pain patients who arrive in the Emergency Department
Why are so many people having open-heart surgery these days?
Atherosclerosis, involving a narrowing of the coronary arteries due to the buildup of plaque in the vessels, is a very common disorder, particularly in older people. The baby boomer generation is aging, now entering their sixties, when cardiovascular disease becomes symptomatic. Particularly in Montgomery County, we are seeing a rapidly aging population, and we expect a boost for the demand in open-heart surgery and therapeutic cardiology procedures such as angioplasty. Additionally, with a better understanding of the deleterious effects of long-term valvular disease and an increasing incidence in atrial fibrillation, more patients are undergoing valve repairs and arrhythmia operations. Minimally invasive techniques have made these operations safer and less traumatic, which also increases the number of patients who are candidates for surgery. Finally, new procedures for the treatment of heart failure, severe coronary artery disease and aortic disease provide more options for patients who were previously considered inoperable.
Are there any new scientific developments in cardiovascular medicine?
There are several areas of research being conducted at the NIH laboratory that we plan on carrying across the street to the Suburban Hospital operating rooms. One is the use of cellular transplant to provide regeneration of heart muscle cells and restoration of heart function for patients who have suffered myocardial infarctions. Initially, we have been employing adult mesenchymal stem cells and are working on understanding the mechanisms and requirements that these cells have to grow and replicate.
A second area of interest is the use of intraoperative MRI to guide surgical procedures. For these studies we will be using the MRI as our eyes and robotics as our hands to perform operations while the patient is in the scanner. This will allow the performance of beating heart valve repairs and replacements with minimal trauma and risk for the patient.
Finally, as there are a growing number of heart-failure patients and as there are too few donor hearts available for transplantation, we are looking to xenotransplantation as a method to solve this problem. The plan is to use porcine hearts as the donor organs and to induce tolerance in the recipients. While the transplant presents an immunologic challenge, recent work in this field is promising and we hope to add significant contributions to make these transplants a reality.