HOW HACKENSACK MERIDIAN HEALTH COMBINES A COMPREHENSIVE CARDIOVASCULAR CARE MODEL WITH ADVANCED TECHNOLOGY AND PIONEERING PROCEDURES

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When New Jersey residents need cardiovascular care, having access to a full spectrum of leading edge treatment options provided by world class specialists is essential. With more than 449 affiliated cardiologists and cardiac specialists across 18 subspecialty areas, Hackensack Meridian Health offers a full range of advanced diagnostic tests and treatments in state of the art facilities all delivered close to home by a multidisciplinary group of experts using the latest technology.

A Collaborative Approach
Years ago, cardiovascular care was divided by subspecialty area. Cardiologists would handle medical management, cardiac surgeons would perform surgery, and interventional cardiologists would perform catheter based and diagnostic procedures in the catheterization lab. Patients would often have to visit several subspecialists at different locations to receive comprehensive care.

Today, members of Hackensack Meridian Health’s care team including cardiac surgeons, interventional cardiologists, cardiologists, vascular surgeons, cardiac anesthesiologists, and lab technicians regularly meet at a Multidisciplinary Team Conference (MDT) to discuss each case, providing each patient with a comprehensive, collaborative treatment plan based on the expert opinions of multiple specialists. Patients then receive treatment from an entire team of specialists during coordinated consultations and procedures, often provided at one location.

“The cardiac specialists and subspecialists at Hackensack Meridian Health work together to provide consultations, perform procedures, and provide patients with outstanding continuity of care,” said Joseph E. Parrillo, M.D., Chair, Heart and Vascular Hospital at Hackensack Meridian Health Hackensack University Medical Center and Chair, Department of Cardiology at the Hackensack Meridian School of Medicine at Seton Hall University. The result, he explained, is personalized, convenient treatment, seamless coordination of care, and improved outcomes for patients.

“Instead of receiving treatment from just one provider, our patients receive care from a team of experts,” said Matthew D. Saybolt, M.D., an interventional cardiologist at Jersey Shore University Medical Center in Neptune. “It really is ‘one stop shopping’ that eliminates the need for patients to travel far and wide to receive the best care.”

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“We have found that our team approach results in lower rates of hospitalization, reduced mortality rates, and better patient outcomes overall,” said Saleem Husain, M.D., an interventional cardiologist at JFK Medical Center in Edison.

State of the Art Facilities
In addition to coming together and collaborating on each case, Hackensack Meridian Health’s cardiovascular specialists have access to state of the art facilities where they perform leading edge diagnostic testing, procedures, and research.

Hackensack Meridian Health’s hybrid operating room facilities combine the features of a fully equipped operating room with the imaging and catheter based technology found in a catheterization lab. Designed to facilitate the expansion of the cardiac surgery, vascular surgery, and structural heart programs, these hybrid rooms provide the capability to perform multiple complex procedures in one location at the same time, allowing for increased efficiencies and a better patient experience.

“These hybrid operating rooms allow us to take advantage of the best real time imaging technology, which helps to guide our hands as we perform minimally invasive procedures from outside the patient’s body,” said Dr. Saybolt.

Hackensack University Medical Center is the third facility in the world and the second in the United States to install the Philips Azurion with FlexArm X ray system in its hybrid operating room. The moveable imaging technology takes low dose X rays and improves efficiency while reducing procedure time, allowing more patients to be diagnosed and treated. Additionally, Jersey Shore University Medical Center’s hybrid operating rooms are equipped with the Innova IGS 5 advanced digital X ray system, which allows providers to see detailed real time images of each patient’s cardiac anatomy.

“This technology represents the best that cardiovascular imaging has to offer, and it is available right here in New Jersey,” said Dr. Parrillo.

In addition to having access to advanced intraoperative imaging technology, providers have access to the latest modeling and imaging tools that allow them to plan entire procedures before setting foot in the operating room.
“When we do a procedure, the team uses imaging and modeling technology to plan the whole thing in advance,” said Dr. Saybolt. “It reduces the chance of surprises in the OR.”

Advanced Treatment Options
Hackensack Meridian Health’s collaborative cardiovascular care model, combined with the most advanced technology, allows its team to offer some of the latest treatment options all backed by extensive evidence and research.

MITRACLIP
Cardiovascular specialists are now offering a minimally invasive treatment for a condition called mitral regurgitation, which occurs when the mitral valve in the heart leaks because it doesn’t close properly. Called MitraClip, it is performed by inserting a thin catheter into a blood vessel through a small incision. With the assistance of intraoperative imaging technology, physicians guide the catheter through the blood vessels to the heart and insert a small clip onto the mitral valve, helping it to close more completely.

Before MitraClip, the only treatment option for mitral regurgitation involved valve repair or replacement performed during open heart surgery a more invasive procedure that requires surgeons to open the chest, resulting in a large incision and a lengthy recovery time.

“Patients who have the new procedure can leave the hospital in two days, as opposed to two weeks after open heart surgery,” said Dr. Parrillo.

But perhaps the most significant benefit of MitraClip is that it provides an additional treatment option for patients who were previously considered to be unsuitable candidates for open heart surgery.

“It’s ideal for those who have other health concerns that make open heart surgery too risky,” said Dr. Parrillo. “Studies show that this is effective for patients with heart failure and a leaky mitral valve, helping them to feel better and live longer.”

“This a proven, effective treatment for patients who have mitral regurgitation and congestive heart failure a previously difficult combination of problems to treat with no proven surgical solution,” said Dr. Saybolt. “I predict that the results of the COAPT trial, which showed a mortality benefit when MitraClip was added to evidence based therapies for congestive heart failure, will result in a paradigm shift in how we treat patients with heart failure and severe mitral valve disease.”

Dr. Parrillo added that Hackensack Meridian Health is also participating in a clinical trial for a new device called Tendyne that can be used to replace the mitral valve during a catheter based procedure.

TRANSCATHETER AORTIC VALVE REPLACEMENT (TAVR)
This is another minimally invasive procedure used to treat a heart valve condition called aortic valve stenosis. Similar to MitraClip, physicians use a catheter to perform TAVR. But instead of clipping the valve, it allows physicians to perform a complete aortic valve replacement with no open heart surgery required.

Although TAVR and MitraClip are used to provide new, life saving treatment options for people who are considered to be too sick to have open heart surgery, Dr. Saybolt explained that these procedures are now being used or researched as alternatives to open heart surgery for healthier people.

“They provide us with options that may offer equal or superior outcomes for some patients when compared to open heart surgery,” he explained. “However, our team will recommend the best treatment option for each patient, and sometimes open heart surgery is still the best option.”

IMPELLA 5.5
Hackensack University Medical Center is one of only three hospitals in the U.S. that has access to a new heart pump called the Impella 5.5 with SmartAssist, and the first hospital in the U.S. to successfully perform procedures using the device.

The Impella 5.5 is inserted into the left ventricle of the heart during a minimally invasive, catheter based procedure. It is used to treat a condition called cardiogenic shock, which can occur after open heart surgery or a heart attack, and takes over the pumping function of the heart during recovery. The device also allows physicians to access real time data collected by the pump through a secure, web based portal.
“This is a real step forward,” said Dr. Parrillo. “It takes minutes to put in and can provide short term pumping support as a patient recovers from a cardiac event.”

Cardiac Rehabilitation
A medically prescribed and supervised exercise and education program designed to reduce risk factors for disease recurrence, cardiac rehabilitation is a critical component of care. Patient participation has been shown to lower mortality rates and reduce the risk of recurrence, as well as boost five year survival rates.
Patients at Hackensack Meridian Health’s JFK Johnson Rehabilitation Institute have access to some of the best cardiac rehabilitation care in New Jersey its staff members committed to providing each patient with the information and assistance he or she needs to enroll in the program.

“Every patient who has a procedure at our hospital receives a visit from our cardiac rehabilitation coordinator during their inpatient stay,” said Dr. Husain. “Our goal is to enroll them in rehabilitation as soon as possible to ensure that they have the most optimal long term outcomes after treatment.”

A Focus on Community
Hackensack Meridian Health’s major academic medical centers as well as its community hospitals deliver comprehensive cardiac care throughout New Jersey. Across the Hackensack Meridian Health network, New Jersey residents have access to the most advanced operating and cardiac catheterization facilities, as well as expert providers and advanced technologies to treat a full range of heart and vascular conditions. From diagnosis through treatment and rehabilitation, this collaborative model along with facilities, technology, and providers work together to promote seamless, high quality care.

“We couldn’t do any of these procedures or offer any of these services without the infrastructure and the team collaboration,” said Dr. Saybolt.

Hackensack Meridian Health
844.464.9355 / hackensackmeridianhealth.org