Cutting-Edge Procedure Saves Patient with Rare Heart Condition

Vol. 18, No. 1
Spring 2008

  • The CyberKnife Challenge: Shrinking Hard-to-treat Tumors

  • Cutting-Edge Procedure Saves Patient with Rare Heart Condition

  • Winthrop Receives Highest Praise From Prestigious Joint Commission

  • Long Islanders Breathe Easier

  • Friendly Sons of St. Patrick Support Winthrop

  • Carleigh McCormack Pediatric Cardiopulmonary Lab Opens at Winthrop

  • Winthrop & Healthtrax: Partners in Wellness

  • Winthrop Celebrates and Honors its Volunteers and Auxilians

  • Yuletide Ball Raises Nearly $170,000 in Support of Pediatric Services

  • Winthrop Volunteers Wrap Holiday Gifts to Raise Funds for Reach Out and Read Program

  • Evening of 'Tasting and Giving' Raises $55,000 for Winthrop's CCFK

  • Astoria Federal Funds Creation of Virtual Resource Center for Diabetes Education

  • Winthrop's New Serenity Chapel Lights the Way for Peace & Hope

  • Winthrop to Undergo Facelift

  • Toshiba Reps Travel from Tokyo to Tour CyberKnife Center

  • Pat Lyons Foundation Supports Survivors of Childhood Cancers

  • Citigroup Foundation Supports CCFK

  • Loads of Toys for Winthrop's Young Patients

  • NY Islanders Visit Pediatrics

  • Winthrop Gets the Gold for Excellence in Stroke Care

  • Winthrop Continues Flu Immunization Program for Seniors

  • Local Homemakers Create & Donate Surgical Dolls

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    Francisca Monsanto (right) with her daughters and granddaughter.
    Fifty-two-year-old Francisca Monsanto of Westbury believes she owes her life to Winthrop's renowned thoracic and cardiovascular surgical team.

    "The doctors made a miracle out of me," said Ms. Monsanto. "I am forever grateful to Winthrop for the excellent care that I received."

    Cutting-edge, specialized care for patients suffering from cardiac diseases to complex aortic reconstruction has been a long-standing tradition at Winthrop-University Hospital.

    "Winthrop has an outstanding reputation as a center of excellence in cardiac care; both its Thoracic & Cardiovascular Surgery Program and Interventional Cardiology Program are recognized state-wide for their excellent outcomes," said Scott Schubach, MD, Chairman of Winthrop's Department of Thoracic and Cardiovascular Surgery.

    Recently, during the induction of general anesthesia for an elective hysterectomy at a local hospital, Ms. Monsanto suddenly began to experience fluctuations in her blood pressure. As a result, she became critically hypotensive - a condition characterized by abnormally low blood pressure - and required aggressive resuscitation. The elective procedure was immediately halted and Ms. Monsanto set out on a medical journey aimed at discovering the underlying cause for the unexpected and potentially disastrous event.

    "Ms. Monsanto had a long history of persistent hypertension which, prior to the elective hysterectomy, was never fully investigated," said John Goncalves, Jr., MD, a renowned cardiothoracic surgeon at Winthrop who specializes in complex reconstruction of both the ascending and descending aorta. "Due to her body's reaction to the induction of general anesthesia, the pathophysiology of Ms. MonsantO's underlying congenital abnormality was eventually unmasked."

    An aortogram - an x-ray examination of the aorta following the injection of a contrast material - revealed a rare congenital aortic malformation - a variant of aortic coarctation with an Interrupted Aortic Arch (IAA). Typically discovered in infancy, an IAA is characterized by the absence or discontinuation of a portion of the aortic arch, between the ascending and descending segments of the aorta, which can cause severe obstruction of blood flow to the lower part of the body.

    "The intricate and unusual circulatory system that Ms. Monsanto had developed as a natural way to circumvent the rare aortic defect enabled her to achieve circulation of blood to her lower extremities," said Dr. Goncalves. "But this unusual circulatory pattern made standard approaches to treatment extremely hazardous."

    Because of the severity of her condition and the complex nature of the surgery that she required, Ms. Monsanto sought several evaluations at healthcare facilities on Long Island and in Manhattan.

    Upon a thorough assessment and evaluation by Dr. Goncalves, Ms. Monsanto felt confident that Winthrop was the right place to have the complex surgery that she required.

    "At Winthrop, I discovered worldclass care right within my own backyard," said Ms. Monsanto.

    Illustration courtesy of the Mayo Clinic
    Dr. Goncalves and Dr. Schubach performed a rare reconstructive surgery known as an ascending- to-descending aortic bypass. This intricate operation involves fashioning a synthetic graft from the ascending aorta, bringing it around the back of the heart and connecting it to the mid-descending thoracic aorta through the posterior pericardium (see Figure 1).

    After a two-month recovery that involved an at-home physical therapy regimen three times a week for three weeks, Ms. Monsanto is feeling better than she has in years. Ms. Monsanto currently sees Winthrop cardiologist Todd Kerwin, MD, for management of her high blood pressure and is now on a lower dose of blood pressure medication.

    Winthrop-University Hospital's renowned cardiothoracic surgery team includes Dr. Schubach, Dr. Goncalves and William Kokotos, MD. The Hospital's Center for Aortic Disease, established in 2004, provides multidisciplinary care to patients suffering from a range of aortic conditions.

    For additional information on Winthrop's world-class Institute for Heart Care, call 1-866-WINTHROP.

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