Hybrid OR/TAVR Procedures

STATE-OF-THE-ART CARDIAC CARE

Hybrid OR at St. Rose

An advanced standard of care is now available in St. Rose Dominican Hospitals’ new state-of-the-art hybrid operating suite. This hybrid operating suite – one of the first in Nevada – provides a state-of-the-art setting where a patient’s multiple health issues can be diagnosed and treated in one place and at one time. The hybrid operating room is a universal operating room that easily adapts to endovascular, minimally invasive, open surgery and hybrid procedures.

It’s a cath lab environment with its high-end X-ray system and trained interventional staff combined with the OR and its highly sterile environment, trained surgical staff, anesthesia and surgical instruments. St. Rose’s hybrid OR also features a high-tech, interactive audio/visual system that allows the cardiac team to call and consult with different specialists when needed.

The Hybrid OR at the Siena Campus was "blessed"
Wednesday, April 4, 2012.

“With the new hybrid OR, we are achieving a higher level of coordination in care for patients who require multiple procedures,” said Rod Davis, president and CEO of St. Rose Dominican Hospitals and senior vice president of operations, Dignity Health Nevada. “This translates to greater comfort, shorter hospital stays and quicker recovery times for our patients.”

Today’s surgical environment is rapidly evolving as interventional treatments and surgeries often overlap. Interventions now treat increasingly complex diseases, while surgical procedures are becoming less invasive, so endovascular and open procedures are often being combined in “hybrid” procedures.

“The support of St. Rose Dominican Hospitals made this new $3 million Hybrid OR possible,” said Dr. Howard Broder, cardiologist. “Cardiologists and cardiovascular surgeons at St. Rose will now be able to use the newest technology and procedures to treat patients who would otherwise be too ill for lifesaving surgeries.”

This merging has created a need for operating rooms that can easily adapt to a variety of procedures, including endovascular, minimally invasive, open surgery and hybrid procedures. The new OR’s equipment quickly and easily adapts to the different setups required for diverse procedures and ultimately results in enhanced patient care, shorter recovery times and lower treatment costs.

The Minimally-Invasive TAVR Procedure

In November 2011, the SAPIEN Transcatheter Heart Valve by Edwards was approved by the FDA as a therapy for adult patients with severe symptomatic native aortic valve stenosis who were determined inoperable for open heart aortic valve replacement surgery by their cardiac surgeons. With the recent opening of the St. Rose Dominican Hospitals’ hybrid OR, this therapy is now available for adult patients who are not candidates for traditional open-heart surgery.

“A multi-disciplinary ‘TAVR Heart Team,’ led by cardiothoracic surgeons and interventional cardiologists, has been through a comprehensive training program that includes procedure and complication management,” said Rod Davis, president and CEO of St. Rose Dominican Hospitals and senior vice president of operations, Dignity Health Nevada.

Up to 1.5 million people in the United States suffer from Aortic Stenosis (AS), and approximately one-third of those suffer from severe AS (usually patients older than 75) which means surgical aortic valve replacement (AVR) is necessary. Studies show that without an AVR, 50 percent of those patients with severe AS will not survive more than two years after symptoms begin.

Prior to the approval of TAVR by the FDA, there were no treatment options available for patients who could not be operated on because of factors such as age, history of heart disease, frailty or other issues. TAVR allows cardiac specialists to deliver and place a new aortic heart valve in the heart through a noninvasive procedure that doesn't require cutting through the sternum or stopping the patient's heart. The procedure builds upon the proven technique of the common, non-surgical cardiac catheterization procedure.

To perform the TAVR procedure, a wireless mesh replacement valve is inserted into a catheter and threaded from an artery in the groin to the patient's heart. Once it's delivered to the site of the patient's diseased valve, the replacement valve is expanded with a balloon and begins to work instantly.

Severe Aortic Stenosis

In elderly patients, severe symptomatic aortic stenosis is often caused by the build up of calcium (mineral deposits) on the aortic valve's leaflets (flaps of tissue that open and close to regulate the one-way flow of blood through the aortic valve). This build up of calcium on the leaflets impairs the aortic valve's ability to fully open and close. As a result, the narrowed valve allows less oxygen rich blood to flow from the lungs to the brain and the rest of the body which may cause symptoms like severe shortness of breath and extreme fatigue.

Rev.2/07/13