Advanced Cardiology Techniques Enhance & Expand Treatment Options at Winthrop's Institute for Heart Care

Vol. 17, No. 1
Winter 2006/2007

  • Advanced Cardiology Techniques Enhance & Expand Treatment Options at Winthrop's Institute for Heart Care

  • Winthrop Elects New Members to Board of Directors

  • Scientific Research is Basic to Winthrop's Mission

  • Weight Management Program Takes Aim at Obesity

  • New Translation Service Breaks Language Barrier

  • Jay's World Foundation Dedicates Fifth Room in Cancer Center Unit

  • Winthrop's Lung Cancer Center: Cutting-Edge, Compassionate & Comprehensive Care

  • Winthrop's Home Health Agency Among Nation's Elite

  • Winthrop's MS Treatment Center Continues to Elevate Standard of Care & Research

  • New Pre-Diabetes Intervention Program Takes Flight at Winthrop

  • Organ Donor Network Medal of Honor

  • McCormack Fund Shows Support for Cardiopulmonary Stress Lab

  • A True Champion

  • Bay's Big Bash

  • The Franceschini Family Supports Colon Cancer Research

  • Evening of Tasting and Giving

  • Lippert Family Dinner Dance Raises $35,000 for Cancer Center for Kids

  • Residency Programs Get the Nod

  • Truckloads of Toys

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  • Tobi Innerfield and Srihari Naidu, MD
    Tobi Innerfield's recurrent mini-strokes and painful migraine headaches are now a thing of the past, thanks to an advanced procedure recently added to the armamentarium of cardiac treatment options available at Winthrop-University Hospital's Institute for Heart Care.

    When Mrs. Innerfield of Wantagh, NY, suffered her first transient ischemic attack (TIA) -- a short-lived stroke with typical neurologic symptoms that do not last long -- she knew right away that something was wrong. As part of her extensive diagnostic testing Srihari Naidu, MD, Director of Winthrop's Cardiac Catheterization Laboratory, performed an Intracardiac Echocardiogram (ICE) -- a sophisticated technique used to look closely at the chambers of the heart. While the rest of her tests were negative, the ICE confirmed that Mrs. Innerfield had a hole in her heart known as an atrial septal defect (ASD) or patent foramen ovale (PFO).

    Every individual is born with a natural opening between the right and left atria -- the upper chambers of the heart. A PFO occurs when the natural hole fails to close after birth. PFOs affect 10 to 25 percent of the global population, and although for most people they pose no serious health risks, it is widely believed that a PFO can increase the risk for a TIA.

    While it has not yet been proven that an ASD/PFO can contribute to the occurrence of a stroke, physicians have noted that many patients with cryptogenic strokes -- strokes with no clear cause -- also have PFOs. Winthrop often refers these patients to a clinical trial, known as the RESPECT Trial, which is currently underway to compare the results of medical treatment for stroke against PFO closure in patients with cryptogenic stroke. Mrs. Innerfield, however, declined participation in the trial, opting instead to go straight for the PFO closure.

    PFO Closure

    Delivered percutaneously (through the skin), ASD/PFO closure carries less risk than open-heart surgery. Instead, a small device, consisting of two tiny disks connected by a spring-like axle, is threaded up through a vein into the patient's heart and inserted into the hole, where it then covers the gap on both sides of the heart muscle wall. The heart cells ultimately grow over the device, creating a living patch in the heart muscle.

    "An ASD/PFO closure is a minimally invasive procedure that is performed without general anesthesia and has many advantages over open-heart surgery," noted Dr. Naidu. "The surgery is performed in 30 minutes and patients can go home the next day."

    Since undergoing ASD/PFO closure surgery at Winthrop on November 2, Mrs. Innerfield has had no more TIAs and, remarkably, no more migraine headaches. Although anecdotal data shows a relationship between migraines and PFOs, no biological explanation has yet been proven. Often, relief of migraines occurs as an unexplained secondary benefit of PFO closure.

    "Before having the ASD/PFO closure procedure at Winthrop, I just didn't feel like myself -- I was pale, sluggish and weak," noted Mrs. Innerfield. "Now, when I see people one of the first things that they comment on is the coloring in my face and how much better I look. It feels so wonderful to be up and about doing things and just simply enjoying life again."

    Coronary Angioplasty at Winthrop
    Winthrop is the ONLY New York State hospital with an overall risk-adjusted mortality rate significantly lower that the statewide rate" for every three-year reporting cycle since 1999. Winthrop is also ranked #1 in New York State for coronary angioplasty in the latest New York State Department of Health report (November 2006 for year 2004).
    Mrs. Innerfield was the first patient to receive ASD/PFO closure at Winthrop since Dr. Naidu brought the procedure to the Hospital upon his arrival in October 2006. Dr. Naidu's extensive experience in percutaneous cardiac intervention makes him a valuable asset to Winthrop and its patients. As director of the Hypertrophic Cardiomyopathy Center at New York Presbyterian Hospital - Cornell Medical Center, Dr. Naidu also mastered a cutting-edge treatment for another dangerous heart defect.

    Alcohol Septal Ablation

    Hypertrophic cardiomyopathy, the most common cause of heart-related sudden death in people under 30 years of age, is a genetic disease that may appear without an obvious family history, and can occur at any age. The condition is characterized by an excessive thickening of heart muscle. As a result, the heart cannot fill with blood properly and is not capable of pumping blood effectively. This dangerous combination can result in shortness of breath, lightheadedness, palpitations and even heart failure. In rare instances, it can lead to sudden collapse and even death during or following vigorous exercise.

    Dr. Naidu is one of a handful of cardiac interventionalists who are treating hypertrophic cardiomyopathy with a new procedure known as alcohol septal ablation (ASA). The treatment is only offered at a few hospitals nationwide and provides a less invasive alternative to open-heart surgery. The procedure takes approximately one hour, during which patients are fully awake. Dr. Naidu injects a small amount of absolute alcohol into the heart to destroy excessive heart muscle in the septum -- the dividing wall between the right and left sides of the heart.

    "Over the years, I have seen many patients and families affected by hypertrophic cardiomyopathy," said Dr. Naidu. "Alcohol septal ablation is currently only offered to patients for whom medical therapy has failed. Although we are very selective about who is a candidate for the procedure, I am confident that in time, it will become a first-line therapy for many people who suffer from this common genetic disease."

    Winthrop-University Hospital's Institute for Heart Care is known for its superior cardiac surgery, interventional cardiology programs and remarkable standards of care. Winthrop-University Hospital ranked #1 in the latest NYS Department of Health study on angioplasty success. In addition, Winthrop is the only hospital in NYS to achieve a risk-adjusted mortality rate significantly lower than the statewide rate for every one of the three-year cycles since the study was commenced in 1999.

    For more information about cardiac care at Winthrop-University Hospital, call 1-866-WINTHROP.

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