A CARDIOLOGIST AT STATEN ISLAND UNIVERSITY HOSPITAL DETAILS NEW TREATMENT OPTIONS FOR HEART DISEASE

BY JESSICA JONES GORMAN • PHOTOS BY AMESSÉ PHOTOGRAPHY

When 84 year old patient with a history of coronary disease and a prior bypass recently arrived at Staten Island University Hospital (SIUH) with severe shortness of breath, Dr. Gregory Maniatis was able to perform a cutting edge, minimally invasive procedure to fix her obstruction.

“Despite her age, she was an active woman who still worked full time selling real estate,” Maniatis explained. “But her breathing was labored after walking just one block, and she had become severely disheartened about her quality of life.”

After an evaluation, SIUH’s cardiology staff determined the cause to be severe aortic stenosis, or a narrowing of the heart’s major valve, a condition that typically causes chest pain, fatigue, and shortness of breath.

“Her aortic valve was failing, not opening fully, reducing blood flow to the body and making the heart work harder,” Maniatis said. “And while a woman of her age would be considered high risk for repeat open heart surgery, she was an optimal candidate for TAVR.”

The minimally invasive procedure, whose unabbreviated name is trans catheter aortic valve replacement, implants a new valve without removing the old, damaged one. Similar to placing a stent in an artery, the TAVR approach delivers a fully collapsible replacement valve through a catheter and is considered a viable option for patients at intermediate or high risk for standard valve replacement surgery.

“The differences in the two procedures are significant,” Maniatis noted. “Valve replacement usually requires an open heart procedure in which the chest is surgically separated. TAVR is done through a very small incision, typically through the groin. This shortens hospital stays and makes recovery more manageable. Our 84 year old patient was home within two days and back to selling homes within a month. Those results alone speak volumes about the power of this procedure.”

Maniatis, who has been performing TAVR at the hospital for almost two years, says it’s just one of the major developments in cardiology at SIUH.“TAVR is one important component of our developing Heart Valve Center and Structural Heart Program,” he noted. “We are proud to offer the most advanced diagnostic and treatment options for heart disease elevating the standard of cardiac care for the local community.”

Offering minimally invasive coronary bypass procedures, heart valve repair and replacements, angioplasties, cardiac catheterizations, and the implantation of cardiac assist devices, SIUH’s Heart Institute offers specialties like interventional cardiology, cardiothoracic surgery, and non-invasive cardiology under one roof.

“This is very much a team approach,” Maniatis said. “All branches nursing, anesthesia, radiology are paramount to the success of each case.”

Maniatis, who specializes in interventional cardiology, said he is continually inspired by the rapid advances in his field. “I think one of the most exciting things is the rapid pace at which they move,” he said. “When I started my fellowship, we were using technology and valve systems that were obsolete by the time I finished. There are new and innovative procedures happening almost on a daily basis. And to participate in the advancement of these technologies and be a part of the team who delivers them it really is an amazing experience.”

Maniatis, who studied economics before enrolling in medical school, did his internship, medical residency, and cardiac fellowships at Rutgers Robert Wood Johnson Medical School. He was inspired to join the medical profession by his father, Dr. Theodore Maniatis, a pulmonologist and critical care doctor who currently serves as SIUH’s medical director.

“I was undoubtedly inspired by my father to enroll in medical school,” he said. “And during my studies I fell in love with the anatomy and physiology of the heart. Then, while I was studying, procedures like TAVR became in vogue. I did an extra year of training to specialize in structural heart disease because I was so fascinated by that procedure itself.”

SIUH is more than the place where Maniatis works. It has, he explained, played a role in all stages of his life. He recalls visiting his father there as a child, and later, when just a teenager, he was hired as a patient transporter. His connection now spans three generations, since, more recently, all three of his children were born at the hospital.

I was born and raised in this community and have very strong ties to this hospital,” he said. “It is with great pride that I am able to serve the patients here.”

Together with Dr. Mohammed Imam and Dr. Chad Kliger, Maniatis has had much success with TAVR. “In our first year, we had 56 cases, with a zero percent mortality rate and a zero percent major complication rate,” he said. “We now have completed about 75 cases, and for a startup program in New York City, those stats are excellent. There is such intense competition from Manhattan programs we are thrilled to offer cutting edge treatment right here,” adding that SIUH’s developing Structural Heart Program intends to take innovation even further. “We’ve formed an effort among non-invasive cardiology, invasive cardiology, and cardiothoracic surgery. We come together as a team to treat complex cardiovascular and valvular heart disease, decide which approach is best for the patient, and then perform a surgical intervention or catheter based therapy. We’re different subspecialties working within the same discipline.”

The team meets weekly, dissecting each case at a conference where the focus is on a multidisciplinary approach.

“Our goal is to be able to provide excellent comprehensive care,” Maniatis said. “I’m lucky to work with an excellent team. Each and every member of our group has made the growth of this program much easier.”

Staten Island University Hospital / Northwell Health
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