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Jon George, MD, Director, Clinical Research and Assistant Director, Cardiac Catheterization Laboratory, Deborah Heart and Lung Center recently had a book published by Nova Science Publishers.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


Interventional Cardiology

Deborah’s Interventional Cardiology Department includes a team of specially-trained interventionalists utilizing highly advanced technologies and devices to open blockages. Offering minimally-invasive techniques and an array of interventional treatment options, Deborah’s Interventionalist give their patients optimal outcomes
 
Atherosclerosis is the process of building plaque in arteries. The plaque-building process can be identified early with vascular risk factor assessment, which helps detect initial and sometimes preventable blockage. With early identification and treatment by highly-trained physicians and nurse practitioners, less-invasive treatment options can be offered. An individual strategy plan can also be developed for the best possible long-term outcomes. Vascular health and maintenance are the foundation of prevention!
 
Vascular health can be maintained with therapeutic lifestyle changes including exercise training, dietary modification, sometimes medication, and tobacco abstinence/cessation. Atherosclerosis in the leg arteries affects the supply of blood and oxygen to the leg muscles. By making a "stress-free" environment in the arteries, plaque buildup is less likely. Improved and sustained vascular-healthy behaviors can help prevent blockages. This is the cornerstone and main building block for excellent vascular health. People who are actively involved in the decision making and management of their artery health overall make better informed choices.  Knowledge is a powerful weapon to save limbs. The treatment for PAD has a number of different options and decision points. Join the movement!

Deborah performs the following interventional procedures: Balloon Angioplasty, Rotational Atherectomy, Directional Coronary Atherectomy (DCA), Stent deployment, Angiojet Thrombectomy, Balloon Valvuloplasty and Excimer Laser Angioplasty (ELCA), Transcutaneous Pericardiocentesis, Right Ventricular Biopsy and Intra-vascular ultrasound.



Minimally-invasive AAA Stent Graft Repair

Deborah’s Interventional Team recently performed a fully percutaneous (using catheters through a puncture in the groin with no incision) abdominal aortic stent graft repair on Albert Walzer of Waretown. Mr. Walzer was thrilled about the outcome of his procedure, having undergone two previous failed attempts for the repair at other prominent hospitals. Shown with Mr. Walzer are Troy Trayer, DO, Richard Kovach, MD, Jon George, MD, and John Cooper, DO.  (Not shown: Kane Chang, MD). These types of repairs, now routinely done at Deborah with these minimally-invasive techniques, hold great promise for patients moving forward.

LARIAT Procedure
Deborah now offers the LARIAT procedure. Used in treating atrial fibrillation, this novel procedure offers hope to patients who cannot take blood thinners to reduce the risk of stroke from this irregular heart rhythm. Two magnetic wires are threaded to the heart's left atrial appendage. One magnetic wire is advanced into the appendage from the inside via a trans-septal heart catheterization. A second magnetic wire is manipulated to the outside tip of the appendage through a catheter inserted via a puncture through the skin, and advanced into the space between the ribs and the heart. When the wires get close to each other, their magnetic attraction joins them together. The appendage is then "lassoed" by a loop stitch advanced over the outer wire to the base of the atrium and tightened. This permanently seals off the left atrial appendage and blocks stroke-causing blood clots from traveling to the brain.



Orbital Atherectomy for the Coronary Arteries
The Orbital Atherectomy is an approved FDA device for clearing calcified blockages in the coronary arteries.  Deborah is the first New Jersey hospital—and first in the Philadelphia region—to offer this minimally-invasive technology. Deborah has been doing orbital atherectomy for several years in peripheral arteries, but this is the first time blockages in the heart have been treated using the same technology.

 

 

 

 

 


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The TAVR Procedure
For high-risk patients with valvular insufficiency who are not candidates for open heart surgery, another option is now available: transcatheter aortic valve replacement (TAVR), a catheter-based alternative treatment not requiring open heart surgery. TAVR produces results in lengthening patients’ lives.
The TAVR procedure can be performed through two different approaches:

Transfemoral approach - In the transfemoral approach, the valve is delivered via a catheter through the femoral artery.

Transfemoral TAVR Indication - The Edwards SAPIEN transcatheter heart valve is indicated for transfemoral delivery in patients with severe symptomatic calcified native aortic valve stenosis, without severe aortic insufficiency and with ejection fraction >20%, who have been examined by a Heart Team including an experienced cardiac surgeon and cardiologist and found to either be: 1) inoperable and in whom co-morbidities would not preclude the expected benefit from correction of the aortic stenosis; or 2) operative candidates for aortic valve replacement, but who have a Society of Thoracic Surgeons predicted operative risk score ≥8%, or are judged by the Heart Team to be at a ≥15% risk of mortality for surgical aortic valve replacement.

Transapical approach - In the transapical approach, the valve is delivered via a catheter through the apex of the heart.


Transapical TAVR Indication - The Edwards SAPIEN transcatheter heart valve is indicated for transapical delivery in patients with severe symptomatic calcified native aortic valve stenosis, without severe aortic insufficiency and with ejection fraction >20%, who have been examined by a Heart Team including an experienced cardiac surgeon and cardiologist and found to be operative candidates for aortic valve replacement, but who have a Society of Thoracic Surgeons predicted operative risk score ≥8% or are judged by the Heart Team to be at a ≥15% risk of mortality for surgical aortic valve replacement. The TAVR procedure is not right for all patients. In certain cases, the risks of the procedure may outweigh the benefits.

Carotids: Before and Aftercarotids

Aorto-Iliacs: Before and After

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Coronary Occlusion: Before and After
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