St. Luke's Roosevelt has a very active Cardiothoracic Surgery Department. This group participates in the innovation of new robotic surgical techniques as well as treats subgroups of patients not always seen in high volume at smaller academic institutions. This year we are working on several projects including a retrospective review of our patients with Hypertrophic Cardiomyopathy (HCM) and a model of lung ischemia-reperfusion injury.
Hypertrophic cardiomyopathy is a complex cardiac disease marked by left ventricular outflow tract obstruction caused by the interplay of several mechanical changes in the heart including both septal wall thickening and changes in the mitral valve structure. At SLR, Dr. Daniel Swistel and Dr. Sandhya Balaram see a large population of these patients and perform a unique surgical repair tailored to address both the pathologic changes of the septum as well as the mitral valve. Mid-term results for our initial 19 patients were published early last year (Balaram et al., Beyond Extended Myectomy for Hypertrophic Cardiomyopathy: The Resection-Plication-Release (RPR) Repair . Ann Thoracic Surgery. 2005;80:217-23). Now our population of patients has more then doubled and we look to examine the both long- and mid- term follow-up of this population as we continue to perform this procedure on an increasing number of people and demonstrate the role for this procedure in HCM surgical care. (http://www.hcmny.org/)
Lung ischemia-reperfusion injury is a common pathway in many disease states including ARDS and lung transplantation. Dr. Faiz Bhora has joined us from University of Pennsylvania where he was working with a team on the development of novel anti-oxidant compounds with targeted delivery to lung tissue. He is looking to continue his research here and collaborate with his colleagues at UPenn to further study the effects of these treatments and their role in preventing ischemia-reperfusion injury.
THORACIC AORTIC ANEURYSM RESEARCH
Research is an integral part of the St. Luke's-Roosevelt Aneurysm Center as we continue to explore better methods of diagnosis and treatment for this disease process. Increased size of the thoracic aorta is associated with an increased risk of rupture, dissection, and death. However, not all ruptures/dissections occur in patients with large aortas. We, in collaboration with the St. Luke's-Roosevelt Division of Cardiology, are currently conducting research to find a more accurate way of measuring risk of rupture.
It is known that reduced aneurysm wall distention correlates with increased risk of rupture. Using tissue Doppler imaging and trans-esophageal echocardiography, we are measuring compliance, strain, and velocity within thoracic aortic aneurysms and normal thoracic aortas. Initial studies are encouraging, showing that mean TDI velocity is significantly different between aneurysm and non-aneurysm patients and there is in fact an inverse linear relationship between aneurysm size and strain rate. As more patients are enrolled in the study, we hope to determine the exact relationship between thoracic aneurysms, aortic wall compliance, and risk of rupture.
From Left to Right: Dr. Sandhya Balaram from the Cardiothoracic Surgery Department, Dr. Eric Martin from the Department of Interventional Radiology, and Dr. John Lantis from the Department of Vascular Surgery collaborate together using a new application of endograft technology for the treatment of thoracic aneurysms.
Dr. George Green pioneered the use of the internal thoracic artery as a conduit for Coronary Artery Bypass Grafting