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occurs when the aortic valve
does not properly open and
close, usually due to a buildup
of calcium. The calcium
build-up restricts blood flow
from the heart to the rest
of the body. This increases
pressure within the heart,
causing heart muscles to
weaken. All of these events
increase the risk of heart
failure. Symptoms of the
disease can include extreme
fatigue, dizziness, chest pain
or pressure, shortness of
breath during activity, rapid
or irregular heartbeat and
fainting.
“Patients who do not
receive an aortic valve
replacement have no effective,
long-term treatment option
to prevent or delay the
progression of severe aortic
stenosis and eventual death,”
said Dr. Scheinerman, noting
that approximately 50 percent
of patients who are in their
80s and have symptoms of
congestive heart failure with
critical aortic stenosis will die
in six months to a year without
treatment. “For patients who
were previously inoperable,
the new TAVR gives hope for
extending and improving the
quality of their lives.”
Dr. Scheinerman, Barry
Kaplan, MD, vice chair of
cardiology at LIJ and North
Shore University Hospital
and an interventional
cardiologist, Rajiv Jauhar,
MD, chief of cardiology
and director of the cardiac
catheterization laboratory and
interventional cardiology at
LIJ, and Robert Palazzo, MD,
a cardiothoracic surgeon,
joined the multidisciplinary
team to perform the procedure
on Mrs. Pszybylski. The
procedure was performed in
the new state-of-the art hybrid
operating room built at LIJ.
The $5 million surgical suite
combines the latest surgical
and cardiac catheterization,
robotic technology and
three-dimensional radiologic
imaging capabilities with realtime
patient monitoring.
“Having all the
equipment and members of
the cardiac team in one OR
saves time and eliminates
the need for a patient to be
moved from one room to
another,” said Dr. Kaplan.
“Interventional cardiologists
and cardiac surgeons are able
to collaborate closely during
the procedure. Working
in our new hybrid surgical
suite allows us to be ready
for any situation or potential
emergency.”
To watch a video featuring the
cardiac team at LIJ who performed
the first TAVR procedures visit
NorthShoreLIJ.com/NSLIJ/vitalityvideos,
or use your smartphone
to scan the QR code.
Hybrid OR:
Making Many Things Possible
By Betty Marton
Two new hybrid operating rooms — the first in Queens and Nassau
County — are letting previously inoperable patients benefit from cutting-
edge combination surgical, cardiac and vascular interventions, including
a life-saving heart valve replacement procedure. Located at LIJ Medical
Center and North Shore University Hospital, these interdisciplinary,
multifunctional rooms allow cardiologists and cardiothoracic surgeons to
perform a range of open, minimally invasive, image-guided and catheter-
based procedures in one operating suite.
“It’s the ideal environment to bring interventional cardiologists and
cardiac surgeons together in a team approach that is relatively unusual and
unprecedented,” explained Barry Kaplan, MD, vice chair of cardiology at LIJ
and North Shore University Hospital.
The hybrid OR incorporates robotic technology and three-dimen-
sional radiologic imaging capabilities with real-time patient monitoring
that, when not needed, can easily be moved out of the way to support
general surgical procedures. Maximizing room use and efficiency makes it
possible to perform such procedures as the Sapien® transcatheter aortic
valve replacement (TAVR) on patients with severe aortic stenosis. TAVR is
performed via the femoral artery, which is similar to the approach used for
cardiac catheterization. The cardiac team then uses transesophageal echo
(TEE) and fluoroscopic imaging guidance for proper placement.
“TAVR only requires a two- or three-centimeter incision, which
allows us to treat patients who were previously deemed inoperable due to
age or serious medical conditions,” said S. Jacob Scheinerman, MD, vice
chair of cardiothoracic surgery at LIJ.
According to Robert Blenderman PA, director of cardiovascular and
thoracic surgery at North Shore University Hospital and LIJ, the $5 million
hybrid surgical suites, built at a time when healthcare dollars are stretched
thin, exemplify the North Shore-LIJ Health System’s commitment to
providing the highest-quality treatment and care for its patients.
“North Shore-LIJ has gone above and beyond in supporting this
hybrid OR technology to meet the needs of future procedures,” he said.
“It’s a beautiful thing to have the ability to offer a quality treatment
to those patients who previously had no other options. This is a
groundbreaking development in cardiovascular surgery and shows our
dedication to growing our discipline in a quality way.”
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