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Consider this if diagnosed with coronary artery disease

Nirav Patel, MD, preps for surgery. He suggests you consider cardiac experience, surgical options and follow-up care if diagnosed with coronary artery disease.

Diverse treatment options, cardiac experience and follow-up care play a major role in managing a life-threatening condition

The statistics surrounding coronary artery disease can be sobering — the condition affects three million Americans each year and is responsible for one in four deaths overall.

While promising new imaging tools using AI can improve diagnosis, what happens if you are among the population suffering from the condition?

Coronary artery disease — an accumulation of fatty deposits in the inner layer of the coronary arteries — does not have to be a death sentence, especially with early diagnosis and the right treatment. And there are many things to consider if you are diagnosed.

Explore your options

Often medications can keep coronary disease from progressing. If further care is necessary, do your homework and look into the various treatment options.

  • Balloon angioplasty uses a small balloon to open the blocked artery.
  • Coronary artery stents are tiny coils that expand to open the blocked area. These are left inside the body to maintain blood flow.
  • Coronary artery bypass graft surgery (CABG) bypasses the blocked portions of the artery with another piece of blood vessel, restoring adequate blood supply.
  • Minimally invasive or robotic techniques allow surgeons to perform bypass surgery using surgical techniques performed through small incisions.

You should also consider if an institution offers trials for new methods and strategies. Lenox Hill Heart & Lung, for example, was one of the leading hospitals to participate in a National Institutes of Health-sponsored trial testing a hybrid, less-invasive approach to the treatment of coronary artery disease. Our research showed that the use of multiple arterial grafts improved patency and is potentially associated with better outcomes.

When to consider a robotic or hybrid surgery

While angioplasty and traditional open-heart bypass surgery are the most common procedures for coronary artery disease, about 20 percent of patients undergoing bypass surgery are candidates for either hybrid bypass surgery or traditional coronary artery bypass grafting.

During a hybrid procedure, the most important artery of the heart is surgically bypassed while the interventional cardiologist inserts stents into the other arteries, restoring blood supply to the heart. 

During robotic surgery, surgeons use state-of-the-art surgical instruments and high-definition cameras to visualize the heart, allowing treatments to be as precise as possible, without a sternotomy — the traditional incision required for heart surgery.

When it comes to bypass surgery, experience matters. Of the 118 sites in the United States doing robotic CABGs, only five are performing more than 40 a year, including Lenox Hill Hospital (about 130 a year).

Cardiac experience

Health care has become a la carte, which has its advantages and disadvantages. It’s good to have options, especially if it is offered close to home. But experience is always best in matters of the heart.

Take a look at an organization’s facilities, doctors and patient outcomes. Successful outcomes are always driven by seamless collaboration between cardiologists, surgeons, nurses and various other specialists within the hospital. All of these factors matter and are vital in the selection of a cardiac program. In fact, Lenox Hill’s outcomes were recognized by the Society of Thoracic Surgeon (STS) — a prestigious national organization made up of more than 7,500 surgeons with the mission of providing the highest quality patient care for patients with heart and lung diseases. STS named Lenox Hill as being among the best in the nation for heart bypass surgery. The New York State Department of Health’s (DOH) Adult Cardiac Surgery report also highlighted the hospital as having the best program in the state for heart bypass surgery.

Follow-up care

Follow-up care can be equally important as cardiac experience. Patients are now encouraged to keep in tune with their care team to adjust their needs as they recover. Some health care organizations offer various programs to recover in the comfort of your home to minimize another hospital visit.

Northwell Health and Lenox Hill’s Follow Your Heart program provides round-the-clock access to your care team via home visits from a specially trained nurse practitioner or physician assistant. These clinicians examine your blood pressure and vital signs, review and adjust medication if needed, and provide additional support. The program has been essential to safer and faster healing, and a better overall patient experience.

Nirav Patel, MD, is director of robotic cardiac surgery for Northwell Health and the vice chair of cardiovascular and thoracic surgery at Lenox Hill Heart & Lung. He has performed thousands of robotic procedures, including the first closed chest, double bypass with the patient’s heart still beating in 2009.

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