The Newest, Cutting-Edge Procedures Unfolding in the Local Medical Community
When the aortic valve narrows, causing chest pain, breathlessness, and weakness, surgery to repair or replace the valve is usually the preferred treatment. But for the old and frail, those who have had open-heart surgery, and those suffering from lung disease, surgery may be too risky.
Now doctors are able to do valve replacements through the groin, helping patients who are not candidates for surgery.“It’s been approved only for a year and it’s still considered very new,” says Dr. Avinash Khanna, a cardiologist with Lakeland’s Clark & Daughtrey Medical Group. “It’s really been picking up more in the last six months.”
“Today we have the capability to replace the aortic valve via a Trans –catheter approach. This procedure, known as the Trans-catheter Aortic Valve Replacement (TAVR), has benefited patients who were before diagnosed as being inoperable because they are unable to undergo a traditional open Aortic Valve Replacement,” says Cateria Davis, Lakeland Regional Medical Center’s (LRMC) perioperative operating room (OR) manager. Davis says the new technology “is giving patients a chance at life again.”
Those with aortic stenosis aren’t the only ones benefitting from new technological advances. New procedures are being developed to treat persistent high blood pressure and help prevent strokes.
In the operating rooms, surgeons are using high definition monitors and robots, meaning procedures are less invasive and patients are recovering faster. “Technology gives our surgeons the ability to visualize in 3D (three dimensions) and the gift of movement intight quarters. For example, with the robot, our surgeons are able to articulate 360 degrees, which of course is not humanly possible with the human arm or hand,” Davis says.
The hospital’s new Hybrid Operating Room offers less invasive procedures, yet physicians are able to perform traditional surgery should it be necessary. “LRMC’s new Hybrid Operating Room gives patients and their doctors a less invasive approach to treating cardiac problems, which ultimately leads to improved outcomes and safer procedures,” Davis explains. “Patients who undergo procedures in the Hybrid Operating Room typically experience less trauma, less scarring, a shorter hospital stay and faster rehabilitation.”
Physicians rely on “real-time intra-operative image guidance to evaluate, intervene and assess the results of minimally invasive procedures, complex minimally invasive procedures, and open surgical cases,” Davis says.
The Hybrid OR supports a “multi-disciplinary approach,” meaning physicians with different specialties can work together more easily. “This holistic approach is designed to limit additional procedures and ultimately reduce hospital stays and possible complications or infections,” Davis says. The hospital’s master plan now includes a surgical suite with the capacity for 17 hybrid-sized operating rooms that can utilize the latest technologies. “. . . Because of ‘daily’ innovations in technology, accelerations in the surgical arena are a mainstay,” Davis states.
The new blood pressure procedure, currently under study in the United States, treats high blood pressure by burning nerves around the kidney, Dr. Khanna says. Called renal denervation, the outpatient procedure would help those whose high blood pressure isn’t under control despite four or five blood pressure medications. The procedure involves putting a tube into the nerves around the patient’s kidneys and delivering heat to those nerves, which is safer than cutting the renal nerves.
Another new procedure, left atrial appendage exclusion, can help reduce the risk of stroke in patients with atrial fibrillation, a heart arrhythmia. It would help some patients who can’t take Coumadin or other blood thinners to protect themselves from blood clots. The procedure keeps clots from moving around by essentially tying off the area, Dr. Khanna points out.
From surgery to wound care, physicians are doctoring in new ways. Using tablets like the iPad to access medical data, and storing charts electronically, are becoming more commonplace. Health care is benefiting as more applications are being developed for mobile devices. One of those new apps was conceived by a Lakeland physician, Dr. Gabriel Delgado, of Lakeland’s Mid Florida Foot and Ankle Clinic. Dr. Delgado wants to make it easier for doctors to track patients’ progress and access treatment options.
For example, using the iPhone, doctors could take photos of their patients’ wounds, and transfer them to their personal computers. By taking photos at each checkup, doctors could evaluate a patient’s healing and determine if treatment is appropriate.
“Doctors love to take pictures,”explains Dr. Delgado, who has medical privileges at Bartow Regional Medical Center. “We teach each other based on photos. The failures and the successes are basically captured by the images.”
He’s been developing the idea for about two years and testing it himself for the last year. Although the app was created for the iPhone and computers running Microsoft Windows,in the future more devices will be supported, he says. Relying on a local network, the photos can be sent securely to the doctor’s computer for storage with patient number and other medical data. The app is designed to enable doctors to sidestep bulky camera equipment and USB connectionsand just use their phone, which they probably are carrying with them anyway. “Very little hardware is involved,”says Dr. Delgado, who formed Lakeland-based Cross Path Tech last year. “The phone itself has so much.”
CREDITS
story by CHERYL ROGERS
