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Advanced Cardiac Imaging Services at Winthrop

Working together to enhance imaging services for cardiac patients, Winthrop- University Hospital�s Division of Cardiology and Department of Radiology recently joined forces to launch a comprehensive cardiac imaging service that combines state-of-the-art diagnostic technology and unprecedented image quality with a team of specially-trained cardiologists and radiologists who provide expert assessments of a wide range of cardiovascular conditions.

Juan Gazta�aga, MD, Director of Cardiac MRI/CT at Winthrop.
�This is a strong collaboration that was established � first and foremost � with the needs of our patients in mind,� said Orlando Ortiz, MD, MBA, FACR, Chairman of the Department of Radiology at Winthrop- University Hospital.

�The unique partnership between Winthrop�s Department of Radiology and Division of Cardiology combines the expertise of two disciplines � interpreting imaging studies and clinical applications � with advanced imaging technology to provide patients with the best possible care,� said Kevin Marzo, MD, Chief of the Division of Cardiology at Winthrop.

�Cardiac CT and MRI are complimentary imaging technologies that greatly assist in the diagnosis of a range of heart conditions including coronary artery disease, diseases of the aorta and structural heart problems including systemic diseases which may affect the heart such as sarcoidosis, amyloidosis and hemochromatosis,� said Juan Gazta�aga, MD, a boardcertified cardiologist and the Director of Cardiac MRI/CT at Winthrop.

Dr. Gazta�aga is responsible for ensuring that these imaging technologies achieve their full potential with cardiac patients at Winthrop. In addition to having completed a fellowship in cardiac medicine at Winthrop and a fellowship in Cardiac MRI/CT at Mount Sinai School of Medicine,

3-D CT image of the heart.
Dr. Gazta�aga holds the highest level of certification (Level Three) for cardiac imaging with CT and MRI by the American College of Cardiology Foundation and the American Heart Association. Dr. Gazta�aga works closely with members of the Hospital�s Department of Radiology including Rakesh Shah, MD, an attending radiologist who completed a fellowship in body imaging at Columbia University and has advanced training in cardiac CT and MRI, with a subspecialty in cardiothoracic and body imaging, to ensure the highest quality imaging studies and interpretations.

�During a CT scan there is always a cardiologist present throughout the entire test, which is unique to our program,� said Dr. Gazta�aga. �The cardiac portion of the exam is read by an experienced cardiologist who is board-certified in computed tomography, and the non-cardiac structures are read by a skilled radiologist. And during an MRI, there is always a cardiologist who is also an MRI specialist present throughout the exam working together with the MRI technician.�

In addition to the expertise of Dr. Gazta�aga and Dr. Shah, the vital support of a team of skilled CT and MRI technicians and nurses who are crosstrained in emergency and trauma care facilitates the seamless delivery of world-class care to patients.

�This is a very integrated program that combines quality interventions with quality staff � radiologists, cardiologists, technologists and nurses � working together to ensure patients receive the best possible care,� said Dr. Ortiz.

Cardiac CT

A cardiac CT scan is a painless, non-invasive study that enables the coronary anatomy to be imaged in seconds with just a small injection of contrast material which generates remarkably detailed images. The test enables cardiologists and radiologists to thoroughly evaluate cardiac function and blockages in the coronary arteries while assessing cardiac structure for other disease. It can also assess a patient�s future risk of heart attack.

�If a patient is having chest pain, a CT scan can help determine if the pain is due to the blockages or narrowing of the coronary arteries that would otherwise be detected with invasive testing,� said Dr. Gazta�aga.

�CT is a great study � it�s quick, easy and safe,� said Joel Marden, CT Technologist at Winthrop.

At Winthrop, the Siemens 128- slice multidetector CT scanner offers powerful imaging technology to provide sharp, three-dimensional images of the heart. The machine is capable of performing scans at very low radiation levels via prospective gating (also known as �Step and Shoot� technology). With the �Step and Shoot� technology, the x-ray tube is only activated during discrete steps of the scanning process, thus reducing the time that is required for scanning and lowering the patient�s exposure to radiation.

�We are committed to taking protective measures to reduce patients� exposure to radiation by utilizing the lowest possible protocols to ensure their safety,� said Dr. Shah. �Without compromising image quality, we are able to dramatically reduce the radiation dose to the patient � which is a vital part of our mission,� he added.

Cardiac MRI

Further enhancing cardiac imaging services at Winthrop is the recent addition of a third MRI system � a new, state-of-the-art Philips 3.0 Tesla MRI scanner. This advanced diagnostic tool uses a combination of large magnets and radiofrequency waves to produce detailed still and moving images of the heart, with no x-ray exposure.

This noninvasive study facilitates the examination of the structure and function of heart muscle, which can reveal the cause of a patient�s heart failure or assist in identifying the specific location of tissue damage due to a heart attack. In fact, cardiac MRI is often referred to as the �gold standard� for evaluating heart function.

�Cardiac MRI is very robust,� said Dr. Gazta�aga. �It�s capable of evaluating cardiac and valvular function; diagnosing heart failure attributed to coronary artery disease and that which occurs independent of coronary artery blockages; as well as cardiac tumors and congenital heart disease.�

For more information about advanced cardiac imaging services at Winthrop, call 1-866-WINTHROP
Vol. 20, No. 1
Winter/Spring 2010

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