The St. Mary Heart Center COMPREHENSIVE. EXPERIENCED ...

The St. Mary Heart CenterCOMPREHENSIVE. EXPERIENCED. ADVANCED.

Heartbeats: Cardiovascular MilestonesFirstopen-heartsurgeryin BucksCountyFirst abdominalaortic stentgraft inBucks CountyFirst FDA-approvedbiventricularICD implant inBucks Countyto treat congestiveheart failureand ventriculartachycardiaNearly4,000proceduresperformedin CardiacCath Labs atSt. Maryeach yearThe St.Medical sincludes50 cardiolcardiotsurgeons fof the namedicalFirst electrophysiologylab in Bucks Countyto diagnose and treatirregular heartbeatsFirst cardiacbrachytherapyin BucksCountyFirst electrophysiologylab in Bucks Countyto utilizestate-of-the-art3-dimensionalcomputerizedmapping system inthe treatment ofarrhythmias400openheartsurgeriesannually1997 1998 2000 2001 2002

Marytaff nownearlyogists andhoracicrom sometion’s topschoolsCardiacrehabilitationprogram awardednational certificationby AmericanAssociation ofCardiovascularand PulmonaryRehabilitationPerformedminimallyinvasivecarotid stentprocedure toprevent riskof stroke inpatients withcarotid arterydisease3-dimensionalechocardiographytechnologyto view highlydetailed, real-timeimages ofhuman heart64-slice CTtechnology todiagnose andtreat lifethreateningillnesses,includingcardiovasculardisease,stroke andchest painFirstcommerciallyavailable drugeluting stentsFirst to implanta cardiacresynchronizationtherapydefibrillatorsystem withautomatic fluidstatus monitoringPerformed25,000thcardiaccatheterizationBuilt two newelectrophysiologylaboratoriesand introducedbiplane imagingtechnology todiagnose and treatatrial fibrillation2003 2005 2006

Dear Fellow Physician:As you know, experience is a prime indicatorof positive outcomes. Your patients will be in thearea’s most experienced hands here at the St.Mary Heart Center. As one of the leading heartprograms in the Delaware Valley, St. Mary performsa wide variety of cardiac procedures.We’ve drawn our team of cardiologists andcardiac surgeons from the nation’s top medicalschools. These physicians, along with specialtynurses and technologists, provide exceptionalheart care for thousands of patients every year.Each member of our team is personally committedto providing you and your patients with topqualitycare and compassion. Through our focuson service and communication, you’ll be anactive participant in that care. You can expect acall from the cardiologist within 24 hours of consultationand, if applicable, again after surgery.You will also receive a copy of all reports.This guide will provide an overview of our capabilitieswhich I hope you’ll find helpful andinformative.Sincerely,Richard T. Leshner, MDChief of Cardiology, St. Mary Medical Center

Noninvasive Diagnostic TestingThe Delaware Valley’s mostcomprehensive facility.No one in the Delaware Valley has a morecomprehensive cardiac diagnostics facilityor a more complete continuum of follow-upcare than St. Mary.• Transesophageal Echo (TEE)• Nuclear Stress Test• Persantine, Dobutamine & AdenosineNuclear Stress• Nonscan Stress Test• Holter Monitor TestLeading-edge technology: St. Mary continuesits commitment to state-of-the-art cardiac imagingby utilizing breakthrough technologies suchas 64-slice CT scanning and three-dimensionalechocardiography. Three-dimensional echocardiography,also known as cardiac ultrasound,enables St. Mary cardiologists to view amazinglydetailed, real-time images of the human heart.High-definition images show a patient’s heart,valves, vessels and chambers in action, allowingfor quick and accurate diagnosis and treatment.Scheduling your patient.Outpatient testing can be scheduled from7:00 a.m. to 5:00 p.m., Monday through Friday.To schedule testing, call 215-710-2521 or215-710-2156.Each year, we test more than 9,000 patients.Depending upon indications and physicalcondition, any of the following non-invasivediagnostic tests can be performed:• Echocardiogram (Echo)• Echo with Definity Contrast• Standard and Dobutamine Stress EchoSt. Mary Heart Center : Comprehensive. Experienced. Advanced.1

• Increased diagnostic capabilities• Reduced imaging timesHigh speed enablesadvanced procedures.64-SliceCT TechnologyGuiding the way withdiagnostic imaging.In 2006, we became one of the first hospitals inthe region to acquire the 64-slice LightSpeed ®VCT.When every second counts, LightSpeed VCTgenerates quick and precise diagnoses oflife-threatening conditions, includingcardiovascular disease, stroke and chest pain.The world’s first volume computed tomographysystem, LightSpeed® VCT is light years beyondprevious CT technology. It benefits both patientsand physicians by providing:• Improved image qualityThis remarkable innovation yields high resolutionin a single rotation, and it acquires a largernumber of thinner images in half the time ofconventional multi-slice CT scanners. By usingLightSpeed® VCT, physicians are able to:• Create three-dimensional views ofpatients’ anatomy• Capture images of a beating heart infive secondsThanks to LightSpeed VCT, St. Mary can offeradvanced procedures such as:5-Beat Cardiac: Physicians can capturepristine, high-resolution images of thewhole heart and coronary arteries in justfive heartbeats.Triple Rule Out: Quick, single scans enablephysicians to confirm or rule out aorticdissection, pulmonary embolism and coronaryartery disease – the three primary life-threateningconditions in patients with chest pains.Stroke Work-Up: Rapid, high-resolution imagesof cerebral blood vessels generated during thecritical one-hour post-stroke window enablephysicians to make a quick diagnosis anddetermine best treatment options.2St. Mary Heart Center : Comprehensive. Experienced. Advanced.

Catheterization LabsA leader in the Delaware Valley.St. Mary’s catheterization labs are amongthe busiest in the region – performing nearly4,000 procedures each year. Our cath labphysicians, staff and technology are availablearound the clock to treat acute myocardialinfarctions with procedures including:• Balloon Angioplasty• Atherectomy• Drug Eluting Stent Implantation• Carotid Artery Stenting• Abdominal Aortic Stent GraftImpressive safety and success.Although our volume is high, we are proud thatour “complication rate” is lower than the nationalaverage. In addition, our “normal” rate (patientswho have normal coronary arteries) for diagnosticcatheterizations is less than 10%, indicating thatpatients are being appropriately selected forinvasive procedures.We are able to achieve this level of performancethanks to:Breakthrough Procedures: We performedBucks County’s first percutaneous transluminalcoronary angioplasty (PCTA) procedure in1997. In 2005, we achieved a milestone of performingmore than 25,000 cardiac, vascular andrenal procedures in our cath labs, making ourteam one of the region’s most experienced.Excellent Nurse Practitioner Support: Ourthree cath lab nurse practitioners provide physicianswith invaluable assistance in delivering thehighest level of patient care. They screen allpatients to identify issues that can impact the outcomeof a study, and implement treatment thatcan affect co-morbidity.Leading Edge Technology: All labs use digitalarchiving. More secure than film, this technologyallows images to be easily duplicated when studyresults are needed elsewhere. IVUS or DopplerFlow Wire technology is available to complementangiography with a picture of arterial wallarchitecture.St. Mary Heart Center : Comprehensive. Experienced. Advanced.3

Other innovative technologies provided in ourlabs include:• Balloon Angioplasty: In many of our angioplastycases, coronary stents are inserted afterclearing blockage to support the tubularstructure of the vessel and keep it open.• Rotational Atherectomy: This techniquewidens narrowed coronary arteries usinga high-speed rotational burr to removeatherosclerotic plaque.• Stents: Approximately 90% of ourinterventional patients are treatedwith drug eluting stents.• Carotid Artery Stenting: This less-invasivetreatment option uses local, rather thangeneral, anesthesia and is demonstratedto have a lower rate of death, myocardialinfarction and stroke in high-risk patientsas compared to traditional surgery.• Cyroplasty: We are the only medical center inthe Delaware Valley to utilize the PolarCathDilation System to treat peripheral vasculardisease. This new technique uses a speciallydesigned angioplasty balloon that fills withcold, liquid nitrous oxide gas to break downplaque and open blocked arteries in the legs.• Amplatzer Closer: We use this device to closepatent foramen ovale and atrial septal defects.The device is passed through a catheter inthe femoral vein and advanced through theinferior vena cava to the right heart andintra-atrial septum. Once in position, thedevice is unsheathed, allowing it to deployacross the defect and close the hole.Same-day Reports: A multitude of factorssurround cath lab procedures. We manage thisvast patient data via the advanced General ElectricCatalyst/Centricity System. Cardiologists use thissystem to develop procedure reports, which canbe faxed to referring physicians as early as the daythe procedure occurs.A Boston Scientific Center of Excellence:The St. Mary Heart Center is one of only threeBoston Scientific Corporation Centers ofExcellence in the nation. Here at St. Mary,Boston Scientific engineers are able to observethe use of leading-edge technology in thetreatment of vascular disease.4St. Mary Heart Center : Comprehensive. Experienced. Advanced.

Electrophysiology LabExperienced team,exceptional success.In 1998, St. Mary established Buck County’s firstelectrophysiology (EP) lab. Today, we are one ofthe most experienced EP teams in the region,performing more than 1,000 cases annually, witha 99.8% event-free rate. And we are continuingto grow to meet the needs of the community.As a result of our ongoing expansion, we nowoffer two new EP labs, which are located on thefirst floor of the medical center.We attribute our low event rate to:The experience of our physicians: Together,our electrophysiologists have performedmore than 5,000 EP diagnostic and treatmentprocedures.Highly Trained Support Staff: Our electrophysiologistsare supported by highly trained andexperienced cardiology nurses and clinicians,dedicated to the science of electrophysiology.Leading-edge technology: St. Mary wasamong the first hospitals in the region tointroduce an atrial fibrillation ablation programutilizing some of the most advanced tools forthese procedures, such as 3-D mapping withupgraded CT cardiac imaging which downloadsdirectly into the mapping system togive the physician a better anatomical pictureof the heart’s endocardium and vessels.Additionally, St. Mary has the capability touse ultrasound guidance to visualize anatomywhen needed.Since its opening, our EP lab has been state ofthe art in every way. As new EP technologyemerges, we evaluate and, when warranted, addit. For example, we were the first in the areato provide the new bi-ventricular ICD.St. Mary Heart Center : Comprehensive. Experienced. Advanced.5

In January of 2005, the St. Mary ElectrophysiologyLab was the first in Bucks County and one ofonly three in the Philadelphia region to implanta cardiac resynchronization therapy defibrillatorsystem with automatic fluid status monitoring.Our lab has the advanced biplane technology todiagnose and treat:• Superventricular Tachycardia (SVT)• Ventricular Tachycardia (VT)• Ventricular Fibrillation (VF)• Bradycardia• Congestive Heart Failure (CHF)To diagnose and treat arrhythmias, we perform:• EP studies• Ablations• Pacemaker and ICD procedures• NIPs• Tilt Table studies6St. Mary Heart Center : Comprehensive. Experienced. Advanced.

Open-Heart SurgeryPerforming more advancedprocedures than anyone elsein the area.St. Mary Heart Center has one of the mostexperienced open-heart teams in the area.We have performed more than 3,000 open-heartprocedures since the inception of the programin 1997. These procedures include:• Coronary Artery Bypass Grafts – mostly offpump• Mitral Valve Repair• Mitral Valve Replacement• Ventricular Assist Device (VAD) insertion• The Maze Procedure• Repair of Aortic DissectionWhy are we the mostpreferred resource?Experienced Surgeons: The cardiothoracicsurgeons who perform all St. Mary open-heartprocedures perform nearly 400 heart surgeries ayear. And we were, in fact, the first to performopen-heart surgery in Bucks County.Attending Physician Involvement: At St. Mary,all open-heart surgeries are performed by theattending physician, so the doctor to whom yourpatient is referred will also perform the surgery.This level of continuity and familiarity not onlyimproves quality, but also increases patientcomfort and confidence.Program Coordinator, Cardiothoracic Surgery:A specially trained and skilled critical care nurse,specializing in cardiothoracic surgery, assists inmanaging each surgeon’s caseload.Leading Edge Open-Heart Technology:St. Mary open-heart procedures are performedin two state-of-the-art ORs, using the latest, mostadvanced cardiac technology. In response tothe growing need for our cardiology services,St. Mary has added a new Cardiovascular CareUnit with dedicated open-heart surgery recoveryrooms and intensive cardiac care rooms.Our Heart Center performs nearly4,000 cardiac catheterizations,400 open-heart procedures, and1,000 procedures todiagnose and treat irregularheartbeats each year.St. Mary Heart Center : Comprehensive. Experienced. Advanced.7

New Cardiovascular Care UnitThe area’s best just got better.St. Mary Medical Center consistently ranks inthe top ten percent in the nation in patientsatisfaction for cardiovascular services.In Bucks County, where cardiovascular illnessaffects more people than any other condition,St. Mary performs more cardiac proceduresthan any other hospital.Now, with our new Cardiovascular Care Unit(CVCU), we extend our leadership position andprovide even more effective treatment.• Centralized work station for EKG monitoring,digital X-ray monitoring, medicationpreparation and dispensing• Bathrooms and showers in private rooms• Overnight pull-out sleep chairs for familymembers• Sinks in hallways and patient rooms toreduce the risk of spreading infections• On-call room for cardiothoracic surgeon• Pharmacy and blood gas lab basedright in the unitIncreasing the scope of care.In the next five years, demand for cardiovascularservices in our region will increase by more than12 percent. The CVCU was developed to meetthis growing need. Part of a $60 million expansionproject, our new unit features:• Open-heart surgery recovery rooms• Private rooms specifically equipped forpatients requiring intensive cardiovascularcare• Decentralized work stations outside eachpatient room enable direct care givers to becloser to patients• Critical equipment organizers reduce clutterin rooms and provide better access to headof bed8St. Mary Heart Center : Comprehensive. Experienced. Advanced.

• Work stations for nutritionist, social workerand heart program care coordinators• Educational conference room• Offices for Nurse Educator and HeartProgram Coordinator• Family reception room, staffed withvolunteer greeter, includes fish tank,comfortable seating, vending area,Internet access and computer kiosk• Connecting hallway to parking garage andeasy access to main lobbyThe new CVCU is a natural extension of St. Mary’salready considerable contributions to cardiovascularcare that include:• A wide range of specialized open-heart surgeries,including mitral and aortic valvereplacements• Repairs of aortic and carotid arteries• Three-dimensional echocardiographytechnology that provides highly detailed,real-time images of the human heartWith the new CVCU, St. Mary provides areapatients immediate proximity to the moststate-of-the-art resources available, as well ashighly trained clinical staff that includes:• Cardiologists and cardiothoracic surgeonsfrom the nation’s top medical schools• Specially trained nurses and registeredtechnicians• A nationally certified cardiac rehabilitationprogram• Patient access to the latest cardiovascularclinical trialsSt. Mary Heart Center : Comprehensive. Experienced. Advanced.9

Expanded Emergency DepartmentMore specialization, morespeed – more advancedemergency heart care.In January 2006, we celebrated the opening ofour newly expanded emergency department.This expansion included the addition of 16 newbeds to help meet the growing number of emergencyroom visits in our community.Our emergency department is equipped withthe most advanced, life-saving protocols to treatheart emergencies:Clinical Decision Unit: Accommodates a shorthospital stay (23 hours) in a comfortable, stateof-the-artcenter. During this period patients canrelax while waiting for results of cardiac diagnosticprocedures, and physicians can determine theneed to admit or discharge patients.Chest Pain: In the area’s most comprehensiveheart center, physicians can locate and openblocked arteries within minutes. We work closelywith EMS to have patients immediately referredto angioplasty. Our goal is to perform it within90 minutes of arrival. We use angioplastyalmost exclusively, because it has been consistentlyproven more effective than clot-dissolvingtherapy. St. Mary is one of a select few hospitalsin the region with advanced cardiovascular care24 hours a day, seven days a week.Stroke: In 2005, St. Mary earned the Gold Sealof Approval for stroke care from the JointCommission on Accreditation of HealthcareOrganizations. Our stroke center bringstogether a 24-hour on-call team withstroke-trained physicians from multiplespecialties, including neurology, neurosurgery,radiology and emergency medicine.In an emergency, no other area hospital isbetter prepared to deliver heart-saving care,with around-the-clock access to state-of-the-artimaging including 64-slice CT imaging, ourhigh-volume cath lab, and our experiencedteam of heart surgeons.10St. Mary Heart Center : Comprehensive. Experienced. Advanced.

Cardiac RehabilitationComprehensive program,remarkable results.Our comprehensive rehabilitation servicesallow us to serve a wide range of patients, fromadolescent to geriatric. Each personalizedprogram is directed by a cardiologist forpatients recovering from:• Myocardial infarction• Coronary artery bypass surgery• Aortic or mitral valve surgery• Coronary angioplasty or stenting• Heart transplant• Angioplasty• Stable angina• Congestive heart failureWe also serve individuals who exhibit two ormore cardiac risk factors.An exceptionally high programcompletion rate.With any exercise program, dropout rates canbe high – but not so at St. Mary. Each year,approximately 90% of our more than 300patients finish their rehab sessions, and manycontinue through the maintenance phase.Designed for success.Our Hearts at Work program (nationallycertified by the American Association ofCardiovascular and Pulmonary Rehabilitation)achieves such a high degreeof patient compliance forseveral reasons:• Our program is offered in threedistinct phases for inpatients,outpatients and those whoneed to maintain a specificexercise program to stay hearthealthy. Within every phase,programs are individualized tomeet the specific needs andchallenges facing each patient.• Our experienced, motivatingstaff includes six exercise physiologists andnurses. All have extensive backgrounds in cardiologyand cardiac rehabilitation. They workin a partnership with physicians, patients andfamilies to develop the best managementstrategy for each individual.• All St. Mary rehabilitation programs arecardiologist-directed. A physician who isfamiliar with all aspects of your patient’scase and history will help develop andoversee the right rehab plan.• We understand the importance of emotionaland mental well-being to successful physicalrehabilitation. Our 2,500-square-foot facilityon the St. Mary campus, overlooking abeautiful lake, helps to raise patients’spirits, maintain a positive outlook andencourage recovery.To refer a patient to cardiac rehabilitation,contact a St. Mary cardiologist (see encloseddirectory).St. Mary Heart Center : Comprehensive. Experienced. Advanced.11

ResearchGiving your patients access togroundbreaking new treatments.As a national leader in important clinical trials,St. Mary gives you and your patients access tothe latest discoveries in the world of cardiology.Eventually these pioneering efforts may lead tonew therapies, techniques and devices thatextend life, improve the quality of life and evenreduce the complications or costs of care.Recent trials at St. Mary Medical Center include:• For additional information regarding this trial,email adoman@che-east.orgSMMC 05-018: SYNTAX: SYNergy Between pciwith TAXus and Cardiac Surgery• Principal Investigator: George Heyrich, MD• Clinical Coordinator: Amy Doman, BSN• For additional information regarding this trial,email adoman@che-east.orgCardiologySMMC 05-013: IMProved Reduction ofOutcomes: Vytorin Efficacy International Trial(IMPROVE IT): A Multicenter, Double-Blind,Randomized Study to Establish the ClinicalBenefit and Safety of Vytorin (ezetimibe/simvastatin)vs Simvastatin Monotherapy in High-RiskPatients• Principal Investigator: Rakesh Shah, MD• Clinical Coordinator: Amy Doman, BSN• For additional information regarding this trial,email adoman@che-east.orgInterventional CardiologySMMC 05-009: APEX-AMI (Assessment ofPEXelizumab in Acute Myocardial Infarction): AMulticenter, Randomized, Double-Blind, Parallelgroup,Placebo-Controlled Study of Pexelizumabin Patients with Acute Myocardial InfarctionUndergoing Primary Percutaneous CoronaryInterventionSMMC 04-024: EARLY ACS – Early GlycoproteinIIb/IIIa Inhibition in Non-ST-segment ElevationAcute Coronary Syndrome: A Randomized,Placebo-Controlled Trial Evaluating the ClinicalBenefits of Early Front-loaded Eptifibatide in theTreatment of Patients with Non-ST-segmentElevation Acute Coronary Syndromes• Principal Investigator: Rakesh Shah, MD• Clinical Coordinator: Amy Doman, BSN• For additional information regarding this trial,email adoman@che-east.orgSMMC 04-033: TIMI-38: A Comparison of CS-747and Clopidogrel in Acute Coronary SyndromeSubjects who are to Undergo PercutaneousCoronary Intervention• Principal Investigator: David Drucker, MD• Clinical Coordinator: Amy Doman, BSN• For additional information regarding this trial,email adoman@che-east.org• Principal Investigator: Rakesh Shah, MD• Clinical Coordinator: Amy Doman, BSN12St. Mary Heart Center : Comprehensive. Experienced. Advanced.

CARDIOVASCULAR SPECIALISTSST. MARY MEDICAL CENTERCardiology Consultantsof PhiladelphiaKevin P. Furey, DOSteven P. Goldberg, MDPaul G. Grena, DODavid S. Kleinman, MDSamuel W. Stever, DOClifford S. Strauss, DO301 Oxford Valley Road, #901AYardley, PA 19067V: 215-321-7400F: 215-321-6803Subrahmanyam Chivukula, MD245 Mill StreetBristol, PA 19007V: 215-785-5100F: 215-785-5101Comprehensive CardiologyAssociates – PAFrank Ammaturo, MDRonald H. Fields, MDLee M. Glickman, MDJonathan Gold, MDRakesh R. Shah, MDDeirdre V. Walsh, MD1205 Langhorne-Newtown Road, #204Langhorne, PA 19047V: 215-750-7818F: 215-752-0436Comprehensive CardiologyConsultants – NJDavid N. Rosvold, MDNeil M. Rothstein, MDMark J. Soffer, MD1 Union Street, #101Robbinsville, NJ 08691V: 609-890-6677F: 609-890-7292Heartcare Associates ofBucks CountyRoberto T. Carvajal, MDBindu C. Kansupada, MDMrugesh B. Patel, MDRajnikant S. Shah, MDAtul D. Trivedi, MD580 Middletown Road, #205DLanghorne, PA 19047V: 215-752-9950F: 215-752-9974Steven P. Kutalek, MDMohammad Al-Bataineh, MDSteven P. Kutalek, MD1205 Langhorne-Newtown Road, #202Langhorne, PA 19047V: 215-757-7212F: 215-757-7274Mercer Bucks CardiologyDavid W. Drucker, MDGeorge P. Heyrich, MDWilliam S. Hirsch, DORichard L. Hyman, MDCharles F. Paraboschi, MDSunder Venkatesulu, MD407 Floral Vale BoulevardYardley, PA 19067V: 215-860-3344F: 215-860-3348Newtown Cardiology AssociatesPaulina Gorodin, MDRichard W. Kass, DORichard T. Leshner, DO1205 Langhorne-Newtown Road, #310Langhorne, PA 19047V: 215-750-6657F: 215-750-2657

CARDIOVASCULAR SPECIALISTSST. MARY MEDICAL CENTEROxford Valley CardiologyAssociates, PCSrinivas S. Atri, MDRanga A. Rao, MD370 Middletown Boulevard, #510Langhorne, PA 19047V: 215-750-6566F: 215-750-7288P.W. Deibert, DOPhilip W. Deibert, DO449 North Pennsylvania AvenueMorrisville, PA 19067V: 215-295-8178F: 215-295-8170Regional Internal MedicineAssoc., Ltd.Andrew C. Friedman, DOMorris I. Rossman, DO390 Middletown Boulevard, #604Langhorne, PA 19047V: 215-750-6777F: 215-702-9430RENU-CA Research Institute, PCRamesh Adiraju, MD501 Bath RoadBristol, PA 19007V: 215-785-9578F: 215-785-9579Mukund V. Sheth, MD825 Town Center Drive, #152Langhorne, PA 19047V: 215-288-1200F: 215-288-6607St. Christopher’s PediatricAssociatesRichard E. Kardon, DOMary C. Sokoloski, MDRamon L. Vogel, MD3601 A StreetPhiladelphia, PA 19134V: 215-427-8836F: 215-427-4822The Arrhythmia InstituteScott W. Burke, MDHope Helfeld, DOMichael J. Rozengarten, MDBradford C. Sodowick, MD1205 Langhorne-NewtownRoad, #408Langhorne, PA 19047V: 215-741-5600F: 215-702-9331Trenton CardiologySamuel W. Madeira, MD1235 Whitehorse-Mercerville, C317Mercerville, NJ 08619V: 609-585-2040F: 609-585-2520

St. Mary Medical Center 1201 Langhorne-Newtown Rd., Langhorne, PA 19047 www.stmaryhealthcare.orgFor physician services, call 215-710-5388. For physician referral, call 215-710-5888.