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Winthrop University Hospital

Patient Breathes Easier Thanks to Advanced, Minimally Invasive Cardiology Technique

It only makes headlines when it suddenly claims the life of a young athlete, but Hypertrophic Cardiomyopathy (HCM) � a genetic cardiac disease � is actually the most common cause of sudden cardiac death in people under 30.

Characterized by excessive thickening of the heart muscle, which makes it difficult for the heart to pump blood effectively, the disease is increasingly recognized as a cause of heart failure, chest pain, shortness of breath and premature death in the teen and young adult population.

Patients with Hypertrophic Cardiomyopathy and other cardiac conditions receive expert care in Winthrop�s John D. Miller Interventional Cardiology Pavilion. The state-of-the-art center was created thanks to a $1,000,000 gift from long-time member of the Hospital�s Board of Directors, John D. Miller. It has enabled Winthrop to better accommodate the increasing number of patients seeking help from the Hospital�s expert team of interventional cardiologists.

The John D. Miller Interventional Cardiology Pavilion features a technologically upgraded Cardiac Catheterization Center, including four state-of-the-science cardiac catheterization labs and a highly sophisticated Electrophysiology Center designed to meet the increasing demand for interventional cardiology services at Winthrop.

�We are extremely grateful for Mr. Miller�s continued support of our Hospital,� said John F. Collins, Winthrop�s President & CEO. �His extraordinary gift has benefited countless individuals who have come to Winthrop for superior cardiac care and will continue to do so in the years to come.�

Present at the dedication of the John D. Miller Interventional Cardiology Pavilion at Winthrop were (l.-r.) John D. Miller; Kevin Marzo, MD, Chief of the Division of Cardiology: John F. Collins, Winthrop�s President & CEO; Todd Cohen, MD, Director of Electrophysiology and the Pacemaker/Arrhythmia Center; Srihari Naidu, MD, Director of Winthrop�s Cardiac Catheterization Laboratory and the Hypertrophic Cardiomyopathy Center; and Charles M. Strain, Chairman of Winthrop�s Board of Directors.

What�s more, HCM often goes undiagnosed well into adulthood either with no symptoms, progressively worsening symptoms, or symptoms that don�t even begin to appear until middle age or later in life.

Winthrop is partnering with the New York Islanders to raise HCM awareness in the community. Working with the NHL team, the Hospital is launching an initiative in local high schools and colleges to help athletes and coaches recognize the warning signs and the importance of the early diagnosis of HCM � the number one cause of sudden cardiac death in athletes. Spokespersons for the program include New York Islander�s left wing Matt Moulson and others who have been impacted first-hand by the disease.
For several years, Wanda Sachs experienced pain and tightness in her chest during normal daily activities on a regular basis. In fact, the 62-year-old resident of Farmingdale couldn�t walk one block without feeling short of breath � symptoms classified by the American Heart Association (AHA) as �Class III,� where patients experience marked limitations during regular activities and are only comfortable at rest.

After comprehensive evaluations by a primary care physician and lung specialist left her still without a diagnosis, Ms. Sachs turned to Winthrop- affiliated cardiologist Matthew T. Chengot, MD. Dr. Chengot administered an echocardiogram, which revealed Ms. Sachs� enlarged heart muscle. Well in tune with the warning signs of HCM thanks to his connection to Winthrop�s Institute for Heart Care, Dr. Chengot promptly referred Ms. Sachs to Winthrop�s Hypertrophic Cardiomyopathy (HCM) Center � Long Island�s first and only HCM Center � for treatment.

Under the leadership of renowned HCM expert Srihari S. Naidu, MD, Director of Winthrop�s Cardiac Catheterization Center, Winthrop�s HCM Center has been designated a Center of Excellence by the national Hypertrophic Cardiomyopathy Association. The Center�s multidisciplinary team of cardiologists, internal medicine specialists, electrophysiologists, surgeons and pediatric cardiologists provide comprehensive, expert care for HCM patients including the latest options in minimally invasive treatment.

After a comprehensive assessment that involved extensive diagnostic testing including a transesophageal echocardiogram (TEE) to test the overall function of Ms. Sachs�s heart valves and chambers, Dr. Naidu presented Ms. Sachs with two options for treatment � open heart surgery with valve replacement, or alcohol septal ablation, a less invasive alternative to surgery.

�Although I had not been in the hospital since my daughter was born over 33 years ago, I wasn�t at all afraid � I had full faith that Dr. Naidu was going to help me.�
Wanda Sachs
Appropriate for patients with severe HCM symptoms who meet strict clinical and anatomic criteria, alcohol septal ablation involves the precisely controlled injection of a small amount of pure alcohol into the thickened septum � the dividing wall between the right and left sides of the heart. The alcohol destroys some of the excessive heart muscle cells on the septum, replacing them with thinner scar tissue, which improves the blood flow out of the heart. Since introducing this advanced technique at Winthrop in 2007, Dr. Naidu has successfully treated dozens of patients � the most of any institution in the New York Metro area.

An angiogram of the alcohol septal ablation procedure performed on Wanda Sachs.
�Alcohol septal ablation is an effective, minimally invasive treatment technique for qualified HCM patients in whom medical therapy has failed,� said Dr. Naidu, who is frequently asked to lecture on and teach the technique both locally and nationally. What�s more, Dr. Naidu was recently appointed to the American College of Cardiology / American Heart Association�s Guideline Writing Committee for the Diagnosis and Management of HCM. These guidelines, due out in 2011, will assist healthcare providers nationwide in clinical decision making for the diagnosis and management of the disease.

Not ready to undergo open surgery, Ms. Sachs opted for the alcohol septal ablation procedure at Winthrop in June 2010.

�Although I had not been in the hospital since my daughter was born over 33 years ago, I wasn�t at all afraid � I had full faith that Dr. Naidu was going to help me,� she said.

The procedure, which takes approximately one hour during which patients are fully awake, was a great success thanks to Dr. Naidu�s extensive experience and the support of a highly skilled team. Within just a few days, Ms. Sachs was up and about, walking around the Hospital unit reveling in the joy of what it felt like to finally achieve relief from her symptoms.

�For the first time in three years, I could walk without experiencing shortness of breath and tightness in the chest � this was unbelievable progress for me!� she said recently.

Now considered by the AHA as �Class 1� � with no limitations during any activities � she enjoys going to the gym and taking walks on the beach with her husband, Alan Griman, whom she married on July 23, 2010. Today, she is grateful for the care she received at Winthrop which helped make it all possible.

�If you have to go to the hospital, Winthrop is the place to go,� she said. �And Dr. Naidu is the kind of doctor that you will never forget � I waited three years to meet a doctor like him!�
Vol. 20, No. 2
Summer/Fall 2010

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