People often don’t give much thought to the exhaustive work of the
heart—the muscle that pumps every second of every day for an entire
lifetime. That is, until something goes wrong: their heart valves become
dysfunctional, an irregular heartbeat disrupts their lives, or a devastating
stroke or heart attack occurs.
Torrance Memorial’s cardiologists perform some of the most innovative
and cutting-edge procedures, many of which have now taken the place of
more invasive open-heart surgery. The team at Torrance Memorial Medical
Center’s Lundquist Cardiovascular Institute led the discussion at
the March 21 Miracle of Living at the Beach—“Advances in the
Care and Treatment of Heart Disease.”
TAVR
Patients travel from all over Southern California to have their heart valves
repaired by the interventional cardiology team at COR Healthcare Medical
Associates, which includes Salman Azam, MD, J. Christopher Matchison,
MD, and Ankush Chhabra, MD.
Speaker Azam received eight additional years of training after medical
school to learn about structural issues of the heart. One of the advanced
procedures he performs is minimally invasive transcatheter aortic valve
replacement surgery (TAVR). The procedure replaces a patient’s aortic
valve narrowed over time causing stenosis, which prevents adequate blood
from exiting the heart and circulating to the rest of the body.
Aortic stenosis affects 16.5 million people in the United States over 65.
In the past, open-heart surgery was the only solution. In this latest
procedure, a new valve is threaded through the patient’s femoral
artery in the groin up to the heart. After this procedure, the patient
is sitting up within six hours and often discharged home the next day.
Torrance Memorial has performed more than 180 TAVR procedures to date.
WATCHMAN™
Torrance Memorial recently became the first South Bay hospital to perform
WATCHMAN™, the newly FDA-approved procedure that corrects a common
electrical rhythm abnormality of the heart known as atrial fibrillation
(AFib). The procedure (detailed on page 12) reduces stroke risk in those
who are unable to tolerate long-term use of blood thinners. Matthew Ostrom,
MD, electrophysiologist, provided an update on this innovation. Dr. Azam,
Sang Yong Ji, MD, Gene Kim, MD, and Erol Kosar, MD, also perform this
procedure.
PREVENTION IS KEY
The panelists concurred that many of the risk factors that lead to heart
damage can be controlled by lifestyle modifications, medications and early
intervention. They aim to treat the modifiable risk factors now, so they
don’t have to see you later with advanced heart disease.
Controllable risk factors include high cholesterol, high blood pressure,
physical inactivity, obesity, type-2 diabetes and smoking. The last two
are the biggest factors. Smoking increases the risk of heart disease up
to four times and diabetes up to three times.
So what’s the first step in reducing plaque build-up in the heart?
First off, recommends Victoria Shin, MD, interventional cardiologist,
know your numbers. This means know your cholesterol, blood pressure and
weight. In addition, exercise more frequently and drink less alcohol.
Dr. Shin warned the women in the crowd to be vigilant. Heart disease kills
292,000 U.S. women every year—far above the 40,000 that die from
breast cancer annually. While risk factors are similar for women as men,
the mortality rate for women is higher and obesity increases this risk.
Also, autoimmune diseases, polycystic ovarian syndrome, history of preeclampsia
or gestational diabetes, and certain breast cancer therapies can affect
women’s hearts.
WORKING AS A TEAM
Torrance Memorial’s Lundquist Cardiovascular Institute, led by event
speaker Mark Lurie, MD, medical director, keeps its eye squarely on the
best possible patient outcomes. At weekly meetings, each surgical case
is evaluated by a multidisciplinary team guided by R. Michael Wyman, MD,
interventional cardiologist.
According to Lurie, Torrance Memorial’s cardiovascular program is
a force to be reckoned with, offering a Structural Heart Disease Program,
Heart Rhythm Center, Diabetes Program, the Cardiac Rehabilitation Program
and Healthy Ever After Kids (to prevent obesity and diabetes in children).
“We work as a team,” says Dr. Azam.”The more minds,
the better the outcomes.”