Page 73

1697_AX_Kundenmagazin_CC.indd

Enhanced Care for Complex Patients The hybrid OR at St. John Hospital has been busy since its debut, supporting more than 900 cases to date. The majority of cases comes from vascular surgery, but the room is also used for neurology, thoracic and cardiovascular procedures, including over 50 TAVR cases. Looking ahead, it will be the preferred site for complex endovascular work that otherwise could not be achieved in either a conventional operating room or a cath lab setting. According to Kumara Rama, MD, vascular surgeon, “To me, a hybrid OR is an absolute must for certain procedures like a thoracic aortic aneurysm, aortic dissection, percutaneous valve, and the c-clip for the mitral valve. These kinds of procedures cannot be done without a powerful C-arm.” Further, the hybrid OR offers new options to patients who would have been excluded from surgery in the past. “With the development and advancement of angioplasty and stents and better long-term results, the number of patients requiring coronary bypass surgery is decreasing,” said Dr. Batra. “As patients are living longer, however, the need for valvular surgery is increasing. As technology advances, we are able to perform these procedures on patients who would not have been operative candidates in the past. But if you don’t have a state-of-the-art facility to perform these procedures, the results will certainly not be what we expect or need.” Dr. LaLonde added, “I think the multidisciplinary approach cultivated within a hybrid OR is of utmost importance. For example, a percutaneous aortic valve procedure requires a cardiologist and a cardiothoracic surgeon working side by side. Therefore, the patient benefits from a hybrid approach to care involving multiple specialties.” Hybrid OR Surgery In addition, patients benefit from physicians’ ability to provide a combined surgical intervention that addresses multiple conditions in a single setting – thereby increasing patient safety, reducing infection rates, and speeding the time to recovery. Tom Davis, MD, Director of the Cardiac Cath Lab and Peripheral Vascular Program, recounts one case involving a patient diagnosed with severe three vessel cardiac disease and a more than 80% stenosis in the carotid. Clinicians accomplished two procedures at the same time. “In the hybrid OR, we started by performing a carotid stent, did our procedure, and then the patient was prepped for bypass surgery. The anesthesia time is shorter for the patient because we did conscious sedation for the stent. From our standpoint, in terms of OR time, the combined procedure is much quicker than a carotid endarterectomy and bypass surgery. Plus, if there are complications, you can have the chest opened up within minutes. I truly believe the hybrid OR is safer for these patients.” Interestingly, the hybrid OR introduces another significant factor linked to patient care: the ability to participate in nationally renowned trials. Dr. Batra explained, “I think having the clinical expertise, the clinical results, and just as important, a world-class facility, will enable us to be selected for trials. This will allow our patients to understand and to appreciate the expertise that we offer. After all, our ultimate goal is patient care – what’s best for the patients and their families.” AXIOM Innovations | December 2013 | www.siemens.com/angiography  73


1697_AX_Kundenmagazin_CC.indd
To see the actual publication please follow the link above