Exciting developments have occurred over the past few decades that have vastly improved heart care. While heart disease is still the #1 killer in the United States, cardiologists and heart surgeons now have the tools to take better care of patients. In fact, if recent trends continue, heart disease – which includes other cardiovascular problems such as stroke – will soon fall behind cancer to drop to spot #2 on the deadly disease list.
Much of the improvement in treating heart disease can be chalked up to interventional cardiology. Interventional cardiologists are doctors who specialize in minimally invasive heart treatments, helping patients avoid open heart surgery. By using thin tubes called catheters, these doctors take advantage of the body’s system of blood vessels to reach the heart.
Once at the heart, interventional cardiologists can unblock arteries, insert stents to keep arteries open, implant ICD devices that shock the heart back into rhythm and replace heart valves, just to name a few procedures.
“Today we fix things we never would have touched before,” says James A. Smith, MD, interventional cardiologist. He and his colleagues at the AdventHealth Pepin Heart Institute work together to offer patients the precise care they need.
Patients with heart disease are often very sick and unable to handle the large operation that open heart surgery involves. Thankfully, today when patients need a new aortic or mitral heart valve, they can have a hybrid procedure. In a hybrid procedure, an interventional cardiologist and a cardiac surgeon work together to provide a minimally invasive solution.
In fact, at the Pepin Heart Institute, it’s not uncommon for four doctors to be in the operating room at once. “It’s the best thing for patients,” says Dr. Smith. This team approach – having the best minds in the room at the same time – gives patients a distinct advantage even if it comes at the cost of the health system or the doctors themselves. Dr. Smith explains that he and his colleagues “prayerfully and carefully” have their patients’ best interest at heart. They do whatever it takes to provide with the care their patients’ situations demand.
“It’s a weighty thing to think about each patient,” says Dr. Smith, “but that’s what we do.”
Leading-edge Interventional Cardiology at AdventHealth Tampa
“We are sitting on the shoulders of engineers,” says Dr. Smith. He says that the medical equipment that he and his fellow AdventHealth interventional cardiologists use continues to improve. While his procedures used to begin with a nick in the skin made to access an artery in the groin, more and more he is using the radial artery in the wrist – a shorter distance to the heart. This is because catheters have become thinner and related instruments and devices more collapsible.
The Pepin Heart Institute has become known as a place that can provide percutaneous intervention (PCI) for patients for whom this procedure is considered high risk. PCI is when catheters are used to unblock arteries in the heart, which provides an alternative to open heart surgery. Dr. Smith and his colleagues can offer high-risk PCI thanks to the Impella heart pump. This temporary pump, inserted through a catheter, gives patients extra blood flow support during their procedures. Studies have shown that patients who have PCI with this pump recover more fully. Their hearts work better than if they had not had the Impella pump.
“Even the Impella has gotten better and smaller,” says Dr. Smith. “Patients now go home the next day after their procedure.”
Minimally Invasive Heart Valve Replacement
Dr. Smith is also part of medical teams that offer minimally invasive heart valve replacement. Transcatheter aortic valve replacement (TAVR), once used only for patients too weak for open heart surgery, is now common for almost all patients who need a new aortic valve. Doctors at the Pepin Heart Institute also provide a similar approach for the heart’s mitral valve, which is more difficult to treat but a problem more people face.
AdventHealth Tampa Heart Doctors Continue to Learn from Each Other
Because of the rise of interventional cardiology, Dr. Smith explains that cardiac surgeons are also doing more and more of their operations with catheter techniques as well. He stresses that the team of doctors and surgeons at the Pepin Heart Institute work well together and continue to learn from each other, young and old alike. And although interventional cardiology has made some of what cardiac surgery does nearly obsolete, the growth in minimally invasive heart procedures has helped both areas.
“We’ve actually seen more referrals back and forth,” says Dr. Smith. He sends his patients to the Pepin Heart Institute cardiac surgeons when they need coronary bypass surgery, and they send him some of their patients for other complex heart procedures.
The teamwork and commitment to doing right by patients no matter what “makes me proud to be part of the program,” stresses Dr. Smith. “It’s part of honoring God in my own life.”
When you need expert care for your heart, trust the team with the right experience, tools and commitment to their patients. For an appointment with an AdventHealth Pepin Heart Institute cardiologist or heart surgeon, call Call813-971-6000.