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CMC balancing technology with patient-centered care



Catholic Medical Center Heart Insitute 

Drs. Robert Capodilupo, left, and James Flynn were the first in northern New England to implant the CardioMEMS device. (Courtesy/Catholic Medical Center)

Courtesy of the Union Leader

February 1, 2016—“Form and function are a unity, two sides of one coin.”  — Ida Pauline Rolf

If form and function are two sides of the same coin, as Ida Rolf once famously said, then it makes sense that Catholic Medical Center's New England Heart and Vascular Institute has found a balance in providing patients with the latest technologies, techniques and procedures in cardiac care while maintaining a patient-centered culture in the delivery of care.

Over the past year, significant progress has also been made with complex cardiac cases, as well as ailments that are more common in our state's adult population. For example, for patients who suffer from vascular disease, the multidisciplinary team at the New England Heart and Vascular Institute provides state-of-the-art surgical, interventional and diagnostic services in both Manchester and other New Hampshire hospitals who work with our clinicians to bring these services directly to their community. This allows patients easier access to state-of-the-art technology and care, closer to home.

Combining traditional patient-centered care with advanced medical procedures has made CMC a top choice among cardiac care patients. The hospital is a recent Union Leader Readers' Choice Award winner for Best Cardiac Care. CMC was also named one of the Nation's 50 Top Cardiovascular Hospitals by Truven Health Analytics for the second year in a row. And Business NH Magazine named CMC the 2015 Healthcare Business of the Year.

“These awards are a tremendous honor, and the result of the outstanding physicians, nurses, administrators and support staff at CMC,” said Dr. Joseph Pepe, president and CEO of Catholic Medical Center. “But for our team, it's not about the recognition; it's about our mission to serve people. Through mission-driven benevolence, we strive to improve the health of vulnerable individuals and communities throughout the state.”

TAVR

That mission also includes making strides to improve the lives of those with aortic valve stenosis (narrowing), which is the cause of more than 25,000 U.S. deaths every year. Seven percent of people older than 65 have the disease. The five-year survival rate for untreated symptomatic patients is just 3 percent. Fortunately, great progress has been made for these patients through a procedure called Transcatheter Aortic Valve Replacement, or TAVR.

Until recently, there were few options to help patients with end stage aortic valve disease because they are often too old or sick to undergo major surgery. Today, TAVR allows patients with severe aortic valve stenosis to have their valve replaced without the need for open heart surgery. To date, CMC has completed more than 100 TAVR procedures within the last 24-plus months.

CardioMEMS

The New England Heart and Vascular Institute has also brought one of the latest approaches in the management of congestive heart failure to our patients. The CardioMEMS HF System is an FDA-approved monitoring device for use in patients with congestive heart failure. It uses a small, wireless monitoring sensor that is implanted in the pulmonary artery (PA) during a right cardiac catheterization to directly measure PA pressure. Since PA pressure changes occur before visible symptoms, such as weight, blood pressure or symptoms or shortness of breath, the CardioMEMS system may alert clinicians early in the process of worsening CHF, potentially avoiding hospitalization.

Patients send their PA pressure data from home to a secure server, which is monitored by the Congestive Heart Failure team at CMC. Patients take a daily reading by using a portable electronic unit and a special pillow. There is no pain or sensation during the readings. Also, the CardioMEMS sensor is designed to last the lifetime of the patient and doesn't require batteries.

WATCHMAN

New England Heart and Vascular Institute is the first hospital in New England to offer the WATCHMAN Left Atrial Appendage Closure Device (LAAC). This device is a new approach in the management of atrial fibrillation (A-Fib). People with A-Fib have a five times greater risk of stroke. The most common treatment to reduce stroke risk in patients with A-Fib is blood-thinning warfarin (also known by the brand names Coumadin, Jantoven, Marevan, Uniwarfin) medication. Despite its proven effectiveness, long-term warfarin medication is not tolerated by some patients and carries a significant risk for bleeding complications. Nearly half of A-Fib patients eligible for warfarin are currently untreated due to tolerance and compliance issues.

The Watchman Implant is a one-time procedure that usually takes about an hour. With the patient under general anesthesia, a cardiologist inserts a catheter into the upper leg and guides it into the heart. On the left side of the heart, the doctor releases the implant from the tube so that it blocks entry to the appendage. After a few weeks, tissue forms over the device, creating a natural barrier. Following the procedure, patients stay overnight in the hospital. Before anticoagulant medications can be discontinued, patients undergo a follow-up test to confirm that the appendage is closed.

“We have so many ways to treat patients and provide better outcomes, and we are excited by what the future brings,” said Dr. Louis Fink, medical director of The New England Heart and Vascular Institute.  “At CMC, we are truly celebrating Heart Month all year long.”

For more information about our treatment options, contact New England Heart & Vascular Institute at 669-0413.

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