Heartbeat The Magazine of St. Francis Hospital The Heart Center®
ORs of the Future High-definition technology moves from the living room to the operating room
Plus:
• Cardiac Arrhythmia 101 • Patient Survey Gives St. Francis Top Marks • Heart Surgery’s New Frontier Newell Robinson, M.D. (right), Director of Cardiothoracic and Vascular Surgery at St. Francis Hospital and cardiac surgical assistant, George J. Abou-Eid, M.D.
Winter 2008-2009
From the
President
In this Issue
Cause for Celebration
From the President 2
The past year was a momentous one for St. Francis, with a significant expansion that positions our Hospital to meet the projected demand for our services well into the 21st century. As we take a look back, there are a number of milestones that were occasions for celebration as well as gratitude.
In the News U.S. News Ranks St. Francis One of the Best 3 Gift of Life’s First Child Reunited with Doctor 3 Mark Hoornstra, M.D., Gets Hands-On with CPR 3 St. Francis Teams up with WFAN for Radiothon 4 Newsday Profiles Three of the “Lucky Ones” 4 Extending the Quality of Life 5 Landmark Study of Coronary Calcium Scores 5 Daily News Prostate Screening at SFH 5
• In January, St. Francis Hospital was selected one of the best places to work in New York state by the Society for Human Resource Management. St. Francis was the only hospital to make the elite list.
Features Arrhythmia 101 6 Joseph Levine, M.D., answers questions about sudden cardiac death and other heart rhythm conditions
• In April, St. Francis was rated the number one hospital on Long Island for patient satisfaction in a national consumer survey conducted by the U.S. Centers for Medicare & Medicaid Services and posted on their Hospital Compare website. • In July, we opened the new Nancy & Frederick DeMatteis Pavilion, the highlight of the largest expansion project in the Hospital's history. Soon after, the 14 new high-tech operating rooms in the Pavilion were up and running, and patients were experiencing the comfort of 184 bright, spacious new rooms. • Also in July, for the second consecutive year, St. Francis was ranked one of the best hospitals in America by U.S. News & World Report. We were the only hospital on Long Island to be ranked in any of the magazine’s 12 medical and surgical specialty categories. The magazine recognized the Hospital in three specialties: heart and heart surgery, digestive disorders, and geriatrics. I am extremely proud of these impressive accomplishments. Even as we look forward to the year ahead, meeting the ever-growing needs of our community and launching the second phase of our expansion and renovation project, it is fitting to thank all of the Hospital’s friends, donors, physicians and staff for the outstanding results of the past year. And special thanks to our patients and their families for their tolerance and understanding during the construction, and, above all, for entrusting us with their care.
Cover Story page 6
New high-tech rooms are designed to increase patient comfort and reduce time in the OR
Head of the Class 11 St. Francis is rated the best hospital on Long Island for patient satisfaction
In OR #1, the Future is Now 12 page 8
In the Name of Friendship 14 Veteran Volunteer Sets Record 15 Campaigning for Excellence 15
Vital Signs page 12
Heartbeat
Vascular Surgery on the Rise 16 St. Francis Opens Its First Sabbath Room 16 Breakthrough Treatments for Digestive Disorders 17 Boomer Orthopedics 18 Cardiac Rehab Celebrates 30 Years of Service 18 A St. Francis Homecoming 19 SFH Receives Heart Disease Research Grants 19 Medical Staff News 19
is published by St. Francis Hospital, The Heart Center. Questions or comments can be directed to St. Francis Hospital, Office of Development and Public Affairs, 100 Port Washington Blvd., Roslyn, New York 11576. Copyright © 2008. All Rights Reserved. St. Francis Hospital is a member of Catholic Health Services of Long Island, the healthcare ministry of the Diocese of Rockville Centre.
Alan D. Guerci, M.D. President and CEO
Heartbeat Winter 2008-2009
Innovative, minimally invasive techniques are the new frontier in heart surgery
Giving Back
Best wishes,
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St. Francis Hospital, The Heart Center ®
In the News U.S. News & World Report Again Names St. Francis as One of the Nation’s Best Hospitals For the second consecutive year, St. Francis Hospital, The Heart Center® has been recognized by U.S. News & World Report as one of the best hospitals in the nation in the magazine’s prestigious annual ranking of medical institutions. Besides being rated as one of the country’s top hospitals for heart care and surgery, St. Francis was also Straight from the heart: Grateful former Gift of Life patient, Grace Agwaru, thanks Dr. Filippo Balboni for helping to save her life.
First Gift of Life Patient Reunited with Her St. Francis Doctor It was truly a heartfelt reunion for Grace Agwaru and Filippo Balboni, M.D. When Grace was a 4-year-old in Uganda, doctors told her parents she wouldn’t live to her 16th birthday. But now, at 38, Grace has defied the odds, thanks to lifesaving open-heart surgery she received 33 years ago at St. Francis Hospital. “She was a lovely child when I first saw her and even lovelier now, ” said Dr. Balboni after being reunited with his former patient more than three decades after the surgery. Dr. Balboni performed a cardiac catheterization to diagnose Grace’s condition after she was flown to the United States by the Rotary Club of Manhasset and became the first child to benefit from their new Gift of Life program. Grace was born with a hole in her heart, but there were no facilities for openheart surgery in her country at the time. Now an agricultural economist, Grace credits Gift of Life and doctors at St. Francis for giving her a new lease on life. “This experience makes me feel special. I have been given a second chance in life,” said Grace. “I am now 38, about 22 years older than the maximum life I had been given by doctors and my health is perfect! I can’t remember the last time I was ill.”
a nationally ranked leader in gastrointestinal disorders and geriatrics. In fact, it was the only hospital on Long Island to be ranked in the magazine’s 12 medical and surgical specialty categories. “To be ranked for a second year in a row is a sure sign of the extraordinary strength of our medical and nursing staff,” said Alan D. Guerci, M.D., President and CEO of St. Francis Hospital. “It is gratifying to see recognition of what I know to be true from my experience at Johns Hopkins–that St. Francis is a world-class hospital.”
ER Director Demonstrates New Guidelines on Hands-Only CPR
According to U.S. News, its annual assessment is meant to aid patients “who
When the American Heart Association came out with its new guidelines for hands-only CPR, Mark Hoornstra, M.D., Director of Emergency Medicine, became the expert of choice for WABC and FOX-TV. Dr. Hoornstra sees the benefits of CPR every day in the Hospital’s busy emergency room, but also had a personal experience that hit the heart of the Big Apple. He helped save an actor who collapsed on stage at Lincoln Center after going into cardiac arrest. Thankfully, Dr. Hoornstra was in the audience and jumped into action. The actor survived to tell the tale and was doing television interviews the next day.
truly need outstanding care” and says that ranked hospitals “are judged not in routine procedures, but in difficult cases across an entire specialty.” Of the more than 5,400 hospitals surveyed, St. Francis was one of only 170 medical centers to be honored. The ranking in heart care places the Hospital among the five top medical centers in New York state.
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In the News Newsday Profiles Three St. Francis Patients as “Some of the Lucky Ones”
WFAN Radiothon for Francesa Fund Is Big Hit The WFAN Radiothon to benefit the Mike Francesa Champions of the Heart Fund had a highly successful debut, generating hundreds of thousands of dollars for underinsured patients at St. Francis Hospital and creating an incalculable amount of good will for the Hospital’s mission to fight heart disease. Nearly a dozen St. Francis physicians and patients took to the airwaves for the 28-hour Radiothon to help raise money for the newly created charity. Half of the more than $550,000 in proceeds will benefit Francesa’s fund to help working men and women who lack adequate health insurance get access to lifesaving cardiac procedures and surgery. The other half will go to the Boomer Esiason Foundation, which supports programs related to cystic fibrosis. Francesa has publicly acknowledged his physician, Richard Shlofmitz, M.D., Director of Cardiology at St. Francis, for providing him with first-rate care, and he wanted to make it possible for others to receive the same quality of care. So the popular radio sports host came up with the idea of creating a charitable fund that's now named after him. “I would like to thank everyone who participated in our Radiothon. It is a credit to the loyalty and generosity of the WFAN audience that they responded during these very tough economic times,” said Francesa. “I thank you all from the bottom of my heart.”
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Three patients who had lifesaving procedures at St. Francis Hospital were profiled in a two-part Newsday series focusing on a bid to cut the high heart disease death rate on Long Island. The three patients featured for their success stories were (from top to bottom): Roy Tucker, 77, a retired MTA subway motorman, who underwent an experimental minimally invasive procedure to repair a leaky heart valve using a device known as the MitraClip. Tucker, who was always tired before undergoing the surgery, says he now feels 200 percent better. Tom Melia, 49, a retired New York City firefighter, who participated in a research study at St. Francis and was given a CT scan. Two days later, when he was about to rappel out of a window during a fire training session, he received a call from the doctor telling him not to jump, but to get to the Hospital instead. He underwent an angioplasty and received two lifesaving stents. Bobby Mazziotti, 14, who suffered a
wrestling injury at age 12 and went to see a doctor for an x-ray. The doctor suggested that Bobby get an EKG, which revealed a “short circuit” in his heart. He was diagnosed with Wolff-Parkinson-White syndrome, an abnormality in which the heart has an extra conduction pathway that can cause rapid heartbeat, dizziness and sometimes heart attack and death. After undergoing an arthroscopic procedure at St. Francis that closed the extra pathway, Bobby is back to playing sports.
St. Francis Joins Forces with the Daily News for Prostate Screening Extending the Quality of Life One-hundred-and-fouryear-old St. Francis heart patient, Hazel Homer, made the front page of The NewYork Times for receiving a specialized pacemaker/defibrillator five years ago at the Hospital. Mrs. Homer’s cardiologist Gary R. Friedman, M.D., did not expect her to live past 100 after she suffered a heart attack at 95, but thanks to a procedure performed by Steven Greenberg, M.D., she has been able to celebrate her 11th decade. Citing increased efforts to improve the quality of very long lives, Dr. Greenberg, who was recently invited to his patient’s 104th birthday party, told the newspaper, “She’s just a peek into the future.”
Felix Badillo, M.D., Chief of Urology, was featured in a New York Daily News article about prostate cancer screening, detection, and treatment. Dr. Badillo’s patient, Michael Borska, was also interviewed. Borska, a cycling instructor, received lifesaving prostate cancer surgery from Dr. Badillo, who used the state-of-the-art da Vinci Robotic Surgical System.
St. Francis CEO Is a Lead Researcher in New Landmark Study of Coronary Calcium Tests President and CEO of St. Francis Hospital, Alan D. Guerci, M.D., was among a team of researchers nationwide who recently discovered that a simple rapid, coronary calcium test, taken into account with traditional risk factors, is the most accurate predictor of possible cardiac events among Caucasians, African Americans, Hispanics and people of Chinese descent. The study, titled the “Multi-Ethnic Study of Atherosclerosis (META),” appeared in The New England Journal of Medicine. Researchers also found that the predictive value of coronary calcium scores, which are performed using fast CT scans, did not vary among the racial and ethnic groups in the study, leading them to believe that findings could apply to ethnic groups not included in the study. “Our findings confirm what earlier, more limited studies have shown–that the amount of coronary calcification in one’s heart and blood vessels, when taken along with other risk factors such as blood pressure, cholesterol levels and body mass, is a reliable predictor of a person’s risk of heart attack or other cardiac event,” said Dr. Guerci.
Felix Badillo, M.D., (left) with patient Michael Borska
The editorial coverage took place in tandem with St. Francis Hospital’s participation in the New York Daily News Prostate Screening Program. More than 170 men were screened at three different locations in Nassau and Queens in an effort to raise awareness about the importance of early detection.
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Q&A Arrhythmia 101 Joseph Levine, M.D., answers questions about sudden cardiac arrest and other heart rhythm conditions
udden cardiac arrest is a phenomenon that has received considerable media attention these days with cases involving prominent athletes and others. To learn more about this serious health problem as well as other heart rhythm issues, we managed to find time on the very busy schedule of Joseph Levine, M.D., Director of Electrophysiology at St. Francis Hospital. Dr. Levine is a world-renowned electrophysiologist, or “electrician of the heart,” who came to St. Francis in 1988 from Johns Hopkins Hospital. He has pioneered major cardiac arrhythmia treatments, such as radiofrequency ablation, that have become the standards in the field, and he has also contributed to groundbreaking research. In addition to these achievements, Dr. Levine is consistently named one of New York Magazine’s “Best Doctors” and recently appeared on the Emmy-Award-winning PBS television special, “The Mysterious Human Heart.” Here’s what Dr. Levine had to say.
S
Joseph Levine, M.D., Director of Electrophysiology
Heartbeat: What are the causes of sudden cardiac arrest? How big a problem is it, and what can people do to protect themselves? Dr. Levine: There are 300,000 cases of cardiac arrests a year with 90 percent of those cases due to ventricular tachycardia (fast heartbeats from the lower, pumping chambers of the heart) and 10 percent due to heart block, which occurs when the electrical signal is slowed or disrupted as it moves through the heart. Most of the time ventricular tachycardia arises from a damaged heart, either due to a heart attack, a viral infection or a blocked artery. Heartbeat: During a recent WFAN radio interview you talked about school kids being prescreened for heart rhythm problems. How early should they be screened? Dr. Levine: I would say the earlier the better, especially for young people who play sports. Heartbeat: What type of tests should parents ask for that will detect potential heart rhythm problems that their child might have? Dr. Levine: Patients should ask for an electrocardiogram (EKG), which will measure the electrical activity of the heartbeat, and an echocardiogram, which measures heart function. Heartbeat: What type of surgeries or procedures do you suggest children have to correct these heart conditions? Dr. Levine: Ablation is the recommended treatment for children who have supraventricular tachycardia (SVT). This condition is due to an
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extra electrical connection between the heart's atrium and ventricle and this extra connection acts as a short circuit that, at times, can result in the heartbeat rising between 150 and 300 beats per minute (normal is 70). If the heart rate increases to over 250 beats, even a normal heart can go into cardiac arrest. An ablation, which can take less than 45 minutes, is done using catheters or plastic tubes that are inserted into intravenous (IV) lines in the leg or neck while the patient is under local anesthesia. There are no stitches and no scars. The catheters, which are flexible plastic tubes that have metal tips, are positioned in the heart under an x-ray. It literally takes a second to position the catheters once the IVs are in. We then record the heart and map out the electrical activity using computers. Once we identify the source of the problem, we move one of the catheters next to the extra connection, heat the tip and the heart tissue to about 120 to 130 degrees F and then cauterize (burn) the connection. The burn is only 4 millimeters in size–about the size of the eraser on a pencil. I helped to develop the technique in the 1980s and David Hoch, M.D., Vinni Jayam, M.D., and I have cured nearly 10,000 persons with SVT over the past 20 years. The procedure has proven safer than a stress test or working out with a trainer at a gym. Heartbeat: What are the most common heart conditions you see patients coming in with and what are your most effective diagnostic tools and treatments?
Kevin Oill (right) and his younger brothers, Christopher and Matthew (left to right) all have an underlying genetic disorder that causes irregular heartbeats. The three boys are under Dr. Levine’s care.
Dr. Levine: Even though most patients come to St. Francis for help with arrhythmia problems related to coronary disease (the most common heart condition affecting Americans) there are other causes. Sometimes arrhythmias can occur as a result of too much stress, not enough sleep, or too much caffeine or alcohol, especially red wine. When we see a patient with an irregular heartbeat, our first goal is to ask whether he or she has a risk of major complications or death from their arrhythmia. Many people have benign or harmless arrhythmias, and if that is the case, we reassure the patient and focus on improving the quality of life. If the patient is at risk for cardiac arrest or stroke, we are aggressive in the diagnosis and treatment. Sometimes we can cure the arrhythmia with radiofrequency ablation or avert a heart attack by referring the patient to an interventional cardiologist. Oftentimes the patient has a damaged heart and the best preventive treatment is an automatic implantable defibrillator, which is a device that monitors the heart rate by using batteries to send electric signals to a heart that's beating too slow, similar to a pacemaker. The implantable cardioverter defibrillator (ICD), which is used in patients at risk for recurrent ventricular tachycardia (a fast heart rhythm that originates in one of the ventricles of the heart) or fibrillation, can also deliver a charge to the heart when it suffers from one of these conditions. This is similar to what is typically shown on television shows when someone is brought into an emergency room, shocked with “paddles” on the chest and then brought back to life. The main difference is that the ICD is implanted and will send the shock automatically. It is 99 percent effective and has been proven to prevent sudden death and to prolong life. Heartbeat: What is the most significant current research study at St. Francis in terms of potential benefits for patients? Dr. Levine: The Arrhythmia Center team and I have been instrumental in understanding the applications for the use of the implantable defibrillator. We have authored many of the major research papers describing the defibrillator's use and are among the elite in the country in understanding the technology and in instituting therapy. Several of the arrhythmia physicians at St. Francis, including Steven Greenberg, M.D., are world-renown implanters of the device. Stuart Schecter, M.D., is among the most experienced clinicians in the world in understanding the Doppler studies and optimizing the devices, not only for use in preventing sudden death, but also to treat heart failure. The team and I have also been instrumental in research involving
new applications of the ICD. Most of the research focuses on the use of a defibrillator for people who are at high risk for sudden death, but remain asymptomatic. If a person in this category suffers cardiac arrest on Long Island, there is greater than a 95 percent chance they will either die or be brain damaged unless an ICD is implanted as a preventive approach before the cardiac arrest strikes. Heartbeat: You are also a proponent of automated external defibrillators (AEDs) being available at public places, although some would argue that this would be costly. Dr. Levine: Having AEDs readily available is very worthwhile, even if it might get costly. How can you put a price tag on a life saved? Heartbeat: The St. Francis Hospital Arrhythmia Center is an international leader in the study, diagnosis and treatment of heart rhythm disturbances. What sets our center apart? Dr. Levine: We use electrophysiology studies (EP Studies) and ICDs for patients at risk for sudden cardiac death. We also use leading-edge techniques such as radiofrequency ablation, and we are by far the safest center in the United States, with very high cure rates for ablations–about 99 percent for SVT. Plus, we are a team of physicians, nurse practitioners, physician assistants, nurses, technicians and secretaries. The Arrhythmia Center is at the top of its game because each person is excellent at his or her job. Ever since we established the Arrhythmia & Pacemaker Center at St. Francis Hospital in 1988, we have been pioneers in shaping developments in electrophysiology. We were among the first in the nation to offer implantable defibrillators and to offer radiofrequency ablation as an alternative to cure certain arrhythmias. It was our idea to use the defibrillator as a tool to prevent an initial sudden cardiac death. These eventually led to more permanent cures and improved management of cardiac rhythm abnormalities. Our physicians continue to be among the nation’s leaders in developing new technologies and applications. St. Francis Hospital, The Heart Center ®
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New Director of General Surgery, Gary R. Gecelter, M.D., and his surgical team get hi-def view during gall bladder surgery.
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Cover Story
St. Francis Unveils First Fully Integrated High-Def ORs New high-tech rooms are designed to increase patient comfort and reduce time in the OR
Imagine being able to see an operation in the same high-definition as the flat screen TV in your living room. That’s what St. Francis surgical teams are now able to do thanks to 14 new ORs in the recently opened Nancy & Frederick DeMatteis Pavilion.
T
he new “Operating Rooms of the Future” feature touch
rooms may help save lives by enabling surgical teams to view procedures
screen technology connected to dozens of high-definition
from multiple camera angles within the OR, thereby helping them to
cameras and monitors. The totally integrated system allows
anticipate and respond more quickly to changing conditions.
surgeons instant access to laboratory data and diagnostic
The totally high-def ORs are the result of a $3 million project aimed at
images such as MRIs during procedures. It also enables them to
making it easier for surgeons to perform minimally invasive procedures by
share data with fellow physicians and broadcast surgery “live” across
providing them with clearer pictures. Though the medical grade technolo-
the globe.
gy is similar to that used for flat screen home televisions, it can also mag-
“We want to create the best possible environment for surgery,” says Alan D. Guerci, M.D., President and CEO. He believes that the high-tech
nify images from inside the body – allowing surgeons to better see a patient’s anatomy.
Grand Opening of DeMatteis Pavilion Marks New Chapter in St. Francis History July 10, 2008 was a milestone day for St. Francis Hospital, with celebratory events marking the much-anticipated opening of the Nancy & Frederick DeMatteis Pavilion. Leading physicians, local dignitaries and major donors joined the St. Francis Hospital Board of Trustees, administration, and staff for a first look at the latest advances in care. The opening ceremonies began with a packed press conference in the morning, featuring State Senator Kemp Hannon as the keynote speaker. Then, doctors, nurses and patients representing “Eight Decades of Patient Care” were reunited in an emotional ceremony that included a Korean patient, Brett Halvorson, who was brought to the Hospital (as a child) by former First Lady Nancy Reagan in the 1980s through the Gift of Life program. The press conference culminated with a prayer and blessing by Bishop William Murphy and a live demonstration of the high-definition features of the new ORs, hosted by Jack Soterakis, M.D., V.P. of Medical Affairs. Three of the Hospital’s top physicians, Newell B. Robinson, M.D., Director of Cardiothoracic and Vascular Surgery; Felix L. Badillo, M.D., Chief of Urology; and Philip W. Perlman, M.D., Chief of Otolaryngology helped demonstrate how the video integration system can be used for robotic and minimally invasive surgery. Major benefactor Nancy DeMatteis was a central figure in both the press conference and a donor event that evening, which featured keynote speaker Bob Catell, Former Chairman and CEO of KeySpan and now Chairman of National Grid. Mrs. DeMatteis and the Bishop cut the ribbon to the main OR, ushering in the next generation in patient care for both cardiac and non-cardiac surgery.
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St. Francis Unveils First Fully Integrated High-Def ORs (continued)
For Comfort and Privacy
In an effort to provide our patients with greater choices and added flexibility, St. Francis Hospital is now offering four suites and single rooms to provide the ultimate care in comfort and privacy.
Surgical teams can view procedures from multiple camera angles.
Surgeons say the enhanced video technology makes it easier for them to perform minimally invasive procedures that are less painful and require less recovery time than traditional surgery. Doctors say it is also particularly useful in performing cardiac and non-cardiac robotic surgery. “There is no other facility like this on Long Island,” says Gary R. Gecelter, M.D., the Hospital’s new Director of Surgery. The internationally recognized expert in minimally invasive oncologic surgery says it was a very strong contributing factor for him being able to transition his practice to St. Francis. “This facility enables surgical
Our new suites include the following amenities: • A private lounge for visitors with a sleeper chair for overnight stays • A refrigerator stocked with beverages such as water and juice • A flat screen television • An upgraded private bathroom with well-appointed shower • Bath essentials, including a bathrobe and soaps • Fine linens Room service with a gourmet menu that is tailored to our patients’ specific dietary requirements is also available from 7 a.m. to 7 p.m., as well as selections from the Hospital’s daily menu.
teams to be more proactive and ensures that we keep pace with future technology,” says Dr. Gecelter. The new ORs are part of a three-year, $190-million master plan to increase St. Francis Hospital’s clinical space by 40 per-
The upgraded rooms will also include these additional amenities: • Daily newspaper delivery • Complimentary television and local phone service • Free parking passes for visitors
cent. It is the largest expansion in the Hospital’s history and is designed to meet projected demand for cardiac and non-cardiac services in the years to come. Karl Storz Endoscopy designed the enhanced video system. Though high-def ORs are considered relatively rare, experts think they may one day become standard. The company says St. Francis is currently the only local hospital to be using its fully integrated system.
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In addition, our state-of-the-art pavilion is Wi-Fi equipped, so patients and visitors can use their computers anywhere. Please note that payment for our suites and private rooms is due upon admission. Reservation requests should be made when booking a procedure. Please call Patient Access at (516) 562-6202 for availability and pricing information.
Head of the Class St. Francis is rated the best hospital on Long Island for patient satisfaction A federal consumer survey shows that St. Francis Hospital, The Heart Center® ranks No. 1 on Long Island and substantially above its state and national counterparts for how patients rate the quality of their hospital stays. The findings are the result of a new initiative by the federal Centers for Medicare and Medicaid Services (CMS) to post consumer information on its Hospital Compare website. To find out how St. Francis rates compared to other hospitals in our area, see the chart below compiled by Newsday, or log on to: www.hospitalcompare.hhs.gov.
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Heartbeat
InOR #1, the Future Is Now Innovative, minimally invasive techniques are the new frontier in heart surgery
Last summer, Jeff Einhorn, a Manhattan interior designer, was visiting the Hamptons when he experienced troubling symptoms: a fast, irregular heartbeat and the feeling he was about to pass out. Because he had been diagnosed with a heart valve condition in his 20s, Jeff, now in his 40s, knew it was time to act. He and a friend quickly considered the options and both concluded the same thing: “Let’s get to St. Francis.”
I
t turned out to be a fortunate decision. Once his condition was
Robinson performed robotically-assisted surgery to repair Jeff’s heart
stabilized at St. Francis, Jeff was referred to Newell Robinson,
valve. Amazingly, a week after the procedure, Jeff was having dinner with
M.D., Director of Cardiothoracic and Vascular Surgery and a
friends at his favorite restaurant in the city, and four weeks later he was
nationally recognized expert in minimally invasive cardiac surgery. Dr.
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back at work full-time as well as working out at the gym.
“The nursing care at St. Francis was incredible. They treated me as if I was a part of their family.” Newell Robinson, M.D. (left), Director of Cardiothoracic and Vascular Surgery at St. Francis Hospital, with his patient, Jeff Einhorn. The da Vinci robotic surgical system (right) is used at St. Francis for both prostate and cardiac surgery.
Jeff’s case is not unique. He is part of a growing group of patients
cedures, including surgical techniques designed to treat certain cardiac
reaping the benefits of advanced medical technology and surgical
arrhythmias or irregular heart rhythms. Two St. Francis surgeons perform
expertise in minimally invasive surgery. While today robotic heart sur-
nearly all of their cases off-pump, i.e., without stopping the heart or placing
gery may be appropriate for only a limited number of patients, the trend
the patient on a heart-lung machine. And nearly 100 percent of cases of iso-
toward less invasive approaches is unmistakable.
lated heart valve repair are performed via a minimally invasive approach.
According to Dr. Robinson, “conventional open-heart surgery today is extremely safe and successful. The
According to Dr. Robinson, in addition to robotic surgery, his depart-
real advances in the future will be in the patient’s
ment is participating in the development of a comprehensive approach
quality of life, as they experience the benefits of mini-
to the treatment of heart failure, with cardiac surgeon, Harold Fernandez,
mally invasive techniques.”
M.D., recently being named Director of Heart Failure Surgery. The depart-
Fortunately, patients who come to St. Francis can
ment is also seeing growth in surgery of the aorta, the largest artery in
find the full range of cardiac surgical techniques and
the human body, which brings oxygenated blood from the heart to the
treatments, all performed by one of the most experi-
rest of the body. James Taylor, M.D., a leading specialist in this area and
enced teams of surgeons in the nation. Over the past
one of the most experienced cardiac surgeons in the nation, was recently
20 years, St. Francis heart surgeons have performed
named Director of Thoracic Aortic Surgery.
over 40,000 open-heart surgeries with outstanding
“Because of the depth and breadth of our experience, we have a histo-
success rates. Studies consistently show that
ry of examining and developing new techniques for the benefit of our
patients fare better when they go to physicians and
patients—from the first surgical implantation of defibrillator, to the use
hospitals that perform a high volume of procedures.
of Heartport in minimally invasive heart repair, to the surgical treatment
In a recent analysis by The New York Times, St.
of atrial fibrillation,” says Dr. Robinson. “The use of the da Vinci robotic
Francis Hospital was ranked number one in the Tri-
system is just the latest chapter in the quest to bring patients better out-
State area in cardiac surgery caseload and in the
comes, increased comfort and safety, and faster recovery times.”
number of surgeons with the most experience. For as
For Jeff , the hallmark of the St. Francis experience is not only his
long as the New York State Department of Health has
physician’s skill, but the quality and caring approach of the nursing staff.
reported and analyzed cardiac surgical caseload, St.
“The nursing care at St. Francis was incredible,” says Jeff. “I had a num-
Francis has ranked number one. This depth of experi-
ber of nurses during my stay and they were all very good. They treated
ence enables the Hospital to explore new approaches
me as if I was part of their family.” Dr. Robinson agrees. “We have the
to care for many patients who otherwise might not
best hospital and nursing staff in the nation,” he says, “and our team
have had treatment options.
approach will enable us to bring cardiothoracic surgery into the 21st cen-
The St. Francis team of seven surgeons is expert in all types of heart surgery, from conventional, open-
tury. The results for patients will be truly remarkable.” For Jeff Einhorn, however, those benefits are not somewhere in the
heart bypass to off-pump coronary artery bypass
distant future, they are here today. At St. Francis, he says, “the care is
(OPCAB), to the newest, minimally invasive valve pro-
amazing.”
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Giving Back Meet the Forchellis
In the Name of Friendship It was because of their strong desire to give back to the community and their friendship with the late Harry T. Barbaris, M.D., Director of Surgery and urologist at St. Francis Hospital that Jeffrey Forchelli, founder and managing partner of the law firm of Forchelli, Curto, Crowe, Deegan, Schwartz, Mineo & Cohn, and his wife Sadie decided to donate $250,000 to the Hospital. The couple, who reside in Lattingtown, New York, gave the money to the Hospital in 2007, in honor of Dr. Barbaris, shortly after he died of pancreatic cancer. The beloved physician befriended Jeff on the golf course at Nassau Country Club and
“I would not want to be in another hospital if I were ill.”
often played with him until he passed away. “If you knew Harry Barbaris, you would donate to St. Francis Hospital, too,” says Jeff. “Harry was a true Samaritan. He was a won-
four daughters and seven grandchildren. Jeff, who also donates to his alma maters, Brooklyn Law School and Wagner College, recently became a member of St. Francis Hospital's
derful representative of St. Francis.” Sadie, a retired real estate manager, agrees. “We had the utmost
Development Committee, which provides oversight for all of the
respect for Dr. Barbaris. He was just a super guy. When he passed on
Hospital's fundraising efforts. He and his wife are very happy to be a
we really wanted to do something in his memory.”
part of the hospital that gave them world-class treatment and allowed
The couple had never discussed donating to the Hospital before, but was more than willing to help out St. Francis, and at the same
them to build a world-class friendship with Dr. Barbaris. “St. Francis is a place like no other hospital. If I had to compare
time, honor their friend's name. St. Francis had been an important
the Hospital to a person, it's someone with the big heart, who is
part of their lives for a while. Sadie had volunteered at the Hospital
concerned about everyone,” says Jeff. “That attitude permeates
from 1992 until 1997 after hearing great things about it from friends
the place from Dr. Alan Guerci right down to the staff, and that is
and people in her community. “I heard that it was the best hospital on
what makes it a special place. We certainly plan to continue to be
Long Island so I wanted to volunteer my time there.”
supportive of the Hospital for years to come.”
After volunteering, Sadie was also treated at St. Francis because of an arrhythmia problem. She says the staff was very involved and caring and that the treatment she received was superior. “I would not
How you can contribute to the Capital Campaign
want to be in another hospital if I were ill,” she admits. Jeff was also treated at St. Francis, but for a hernia. He needed to have
St. Francis Hospital is a not-for-profit 501(c)3 tax-exempt institution. To make
surgery and it was Dr. Barbaris who found the right doctor and guided
a gift to the Hospital, please call the Office of Development at (516) 705-6655
him through the entire process. “The morning I had surgery Harry was at
or mail your donation to:
the Hospital to tell the doctor to do a good job,” Jeff recalls. “He was
St. Francis Hospital Foundation
there even though at the time he was recovering himself.”
Office of Development & Public Affairs
Jeff and Sadie are doing fine today. Both are very active–Jeff loves golfing and boating while Sadie enjoys tennis and golf as well. The couple is also busy with their large, close-knit family that consists of
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100 Port Washington Blvd. Roslyn, NY 11576
Giving Back Meet Arlene Miller
Veteran Volunteer Sets New Record for Most Accrued Hours Ninety-one-year-old Arlene Miller believes it’s better to give than to receive, and she lives up to the popular saying every day. The veteran volunteer has set a new record by accruing 29,000 hours, the most ever for a St. Francis volunteer. The grand total is the equivalent of more than 3,600 workdays, but for Arlene, it’s a gift well spent. “Giving my time to others makes me feel young at heart,” says Arlene, who began volunteering at the Hospital three decades ago, after her husband’s death. “There are only so many times you can go to lunch with friends,” says Arlene. “I felt there was something more I should be doing with my free time.” A long time member of the Guild of St. Francis Hospital, the Hospital’s
Campaigning for Excellence St. Francis continues its capital campaign to raise over $70 million by 2011 to fund the Master Facilities Plan (MFP), the largest expansion and renovation project in the Hospital’s history. Upon its completion, patients and visitors will find that the setting at St. Francis Hospital reflects the same qualities of compassion and excellence that distinguish its delivery of care. As of October 1, 2008, more than $55.4 million was raised to help fund the new Nancy & Frederick DeMatteis Pavilion, a 158,000-square-foot, high-tech facility designed to meet the projected demand for cardiac and non-cardiac services. Now the Hospital will focus on raising the remaining $15 million to support renovations to The Heart Center. The resulting world-class center for care will feature: • An Emergency Department, expanded to nearly double its previous size and features a dedicated imaging suite for prompt diagnosis of cardiac and non-cardiac conditions alike
fundraising auxiliary, Arlene drives herself to the main campus to volunteer. She has taken care of all of the Guild's accounting books for almost 30years–all of the work done by hand, no less. The minimum age for a volunteer at St. Francis is 14, but the average is 70 years old. The Hospital is also seeing more and more baby boomers, who are coming out of the workforce, but who are not yet ready to retire. Neither is Arlene. She believes her active life as a volunteer helps keep her sharp and spry, despite her years. She says when she turned 90, she couldn’t believe it. “I thought my mother made a mistake on my birth certificate,” says Arlene, with a warm smile.
• Semi-private and private patient rooms in The Heart Center, renovated to meet the same standard of quality and level of amenities as the rooms in the new pavilion • Newly renovated cardiothoracic operating rooms that will accommodate the latest advances in surgery including the da Vinci robot and other minimally invasive techniques • A new third-floor recovery unit which supports the ORs, where patients are closely monitored following surgery in a private setting adjacent to the ORs • The addition of a seventh cardiac catheterization lab, to support one of the nation’s leading programs for cardiac catheterization and angioplasty techniques such as stenting • A new cardiac catheterization staging and recovery unit, which will provide patients with comfort and privacy before and after a procedure in a spacious unit with dedicated nursing care
Pinning her hopes on youth: Veteran volunteer Arlene Miller (lower left) welcomes the next generation of volunteers at St. Francis Hospital. From lower left to right: Kanika Ramchandani and Isha Gupta. From upper left to right: Karam Gupta, Shaan Shivdasani, Harry Weisberg and George Skevas.
There are now 192 total gifts to the campaign and of those, 90 are major gifts of $100,000 and above. St. Francis will continue to look to the community, grateful patients and foundations for additional campaign gifts. Just recently, the Hospital introduced the Employee Brick Campaign, allowing staff members to purchase a brick that will eventually create a campus walk of fame consisting of commemorative bricks inscribed with special messages. St. Francis Hospital, The Heart Center ®
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Vital Signs Vascular Surgery on the Rise at St. Francis Vascular surgery is an expanding surgical specialty in which diseases of the arteries and veins are treated by using minimally invasive catheter-based procedures or more direct surgical intervention or reconstruction. Last year, Richard Matano, M.D., Chief of Vascular Surgery at St. Francis, performed well over 900 vascular procedures. From treating aortic aneurysms to varicose veins, Dr. Matano has seen many different patients with a wide range of medical Richard Matano, M.D., Chief of Vascular Surgery issues. “Vascular surgery is quite varied in the types of patients that we deal with,” he explains. “From the young, healthy patient who wants a cosmetic result for his or her leg, to the very sick patient in their 80s with edema, as well as the patient who has a large aneurysm–we see it all.” Lately, Dr. Matano and his team have been treating patients who suffer from embolisms (blood clots) in their leg arteries, which can lead to ischemia, a condition in which the blood flow (and oxygen) is restricted to a part of the body. It’s an urgent problem that requires either an embolectomy (a surgical procedure that removes the clot) or medications to dissolve the clot. Surgery to treat varicose veins surgery has evolved over the years. “It used to be treated with very long surgical procedures and painful cuts, but now more varicose vein procedures are done in the doctor’s office,” says Dr. Matano. The procedure, which is performed with catheters, wires or lasers, produces good cosmetic results. Patients who suffer from leg cramps, swelling or ulcers can be treated with these catheter-based procedures in the office as well. Vascular surgeons also work with a large number of dialysis patients. According to Dr. Matano, these patients require access for hemodialysis (the most common method used to treat advanced and permanent kidney failure), whether it’s a fistula, graph or various catheters that are placed for immediate access so dialysis can be performed. The Vascular Surgery department at St. Francis has the second largest caseload of abdominal aneurysm repairs in New York State. St. Francis is one of the first hospitals in the country to perform endovascular repair of aortic aneurysms, and has an excellent success rate in implanting stents. The Hospital also performs the state’s largest caseload of carotid endarterectomy, a surgical procedure to remove plaque in blocked carotid arteries in the neck that supply oxygen to the brain.
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St. Francis Hospital Opens Its First Sabbath Room In order to better meet the needs of families of Orthodox Jewish patients, St. Francis Hospital has opened a new Sabbath Room. The two-bedroom, one bath suite is equipped with a fully stocked kitchen and is available on a first come, first served basis as a hospital courtesy. Tovah Brill, a pharmacist at Mercy Medical Center whose husband was once a patient at St. Francis, came up with the idea. With help from Drs. Chaim and Meyer Abittan, two brothers who are not only St. Francis physicians, but rabbis as well, an appropriate space was found. “We hope this will give our patients’ families a peaceful place to sleep and pray during the Sabbath, that will also give their loved one peace of mind knowing they are close by,” said Chaim Abittan, M.D. According to Hospital statistics, Jewish patients are the second largest segment of the St. Francis patient base, after Roman Catholics. Kosher meals are always available to patients and their families, as well as access to spiritual care. The Hospital also is exploring the idea of installing kosher vending machines. Anyone interested in requesting the Sabbath Room can call the Office of Pastoral Care at (516) 562-6720.
The Women’s Center of St. Francis Hospital... where setting up a test is quick and convenient and you usually receive same-day results. For more information, call: (516) 629-2400.
Breakthrough Treatments for Digestive Disorders Many new avenues of feet of small intestine that really needs to be examined.” Dr. Celifarco says that even though capsule endoscopy allows evaluating potential gastrointestinal disorders doctors to find lesions, many times they are not able to reach are opening up for the lesions with a standard endoscope. That is where balloon patients and St. Francis assisted enteroscopy, a visual examination of the small bowel Hospital is one of the few using an endoscope, plays a role. “With this procedure we can places in the region look deeper into the smaller intestine to find lesions that we where patients can find were not able to reach before with conventional measures,” them. Endoscope acces- says Dr. Celifarco. “More importantly, balloon assisted enteroscopy offers therasibility to the small Anthony Celifarco, M.D., Chief of Gastroenterology bowel has been a chal- py instead of patients having to go into the operating room to lenge for gastroenterologists for decades, but the advent of cap- undergo laparotomies to evaluate the small bowel. Many times sule endoscopy now gives physicians a non-invasive way of imag- this fails to show any abnormality. So the balloon enteroscope ing the small bowel in patients being evaluated for gastrointesti- allows us to reach further into the small bowel to find, diagnose and potentially treat those bleeding nal bleeding, bowel tumors, Crohn’s dislesions,” adds Dr. Celifarco. ease and celiac disease. He also says that physicians are Capsule endoscopy is performed now identifying more cases of using a disposable miniature undiagnosed Crohn's disease video camera contained in a “pill” and celiac disease as a result of swallowed by the patient. The sinboth capsule endoscopy and balgle-use capsule passes naturally loon assisted enteroscopy. “These through the digestive tract, transmittwo procedures have complemented ting high quality color images to a recording belt worn around the waist, Easy-to-swallow pill cam gives surgeons an inside look at the G.I. tract. each other. The capsule endoscopy finds without interfering with the patient’s normal activities. It is elim- lesions while balloon assisted endoscopy reaches them, diagnoses and treats them,” he concludes. inated naturally the next day. St. Francis Hospital is one of the few hospitals in the region to offer balloon assisted enteroscopy. The gastroenterology A Non-Invasive Photo Op “About five to 10 percent of people have gastrointestinal bleeding department is presently seeing many referrals from local hosthe cause of which is difficult to diagnose,” explains Anthony pitals and other gastroenterologists because the procedure is Celifarco, M.D., Chief of Gastroenterology at St. Francis Hospital. not readily available. Advance treatments such as these are one of the reasons that “Capsule endoscopy has allowed us to isolate specific abnormalities that have caused bleeding. However, when we find those St. Francis is the only hospital on Long Island to be nationally areas, the conventional endoscope has only allowed us to look at ranked for the treatment of digestive disorders by U.S. News & the upper one to two feet of the small bowel. There is about 25 World Report.
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Vital Signs Boomer Orthopedics Orthopedic surgeons are noticing more baby boomers in their offices these days. “Not only are we seeing more orthopedic cases, we are seeing a huge increase in both total hip and knee replacements,” says Richard D’Agostino, M.D., Chief of Orthopedic Surgery at St. Francis Hospital. Dr. D’Agostino says that over the last seven years there has been a 71 percent increase in total hip replacements (THR) and an 83 percent increase in total knee replacements (TKR) among 45 to 64 year-olds in the United States. If this trend continues, 600,000 THRs and 1.4 million TKRs will be performed by the year 2015. This could be because baby boomers are remaining more active as they get older, but it could also be a result of the nation’s issue with weight. “About 65 percent of our population is overweight,” explains Dr. D’Agostino. “And if you have arthritis, being overweight will make matters worse.” The good thing is that most patients are finding that their THRs and TKRs are lasting longer and performing well even at 20 years post-operation. Also, there are currently less invasive options for patients needing replacement procedures, including hip resurfacing, where the surface of the damaged femoral head is removed and a prosthetic “cap” is placed over the femoral head. This maintains most of the normal anatomy of the hip joint. Dr. D’Agostino says the procedure is similar to “re-treading a tire” and very popular among baby boomers. Another less invasive option is the unicondylar knee replacement, where surgeons replace only half of the joint. It is performed if the damage is limited to one side of the joint only, with the remaining part of the knee joint being relatively spared. “The good news is that the baby boomer generation is more fit and healthier than prior generations,” concludes Dr. D’Agostino. “However, they wish to remain active well into their later years. We can help them achieve their goals through exercise, good nutrition and the use of new surgical techniques if necessary.”
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St. Francis Hospital, The Heart Center ®
Cardiac Rehab Celebrates 30 Years of Service
Gearing up for the next 30 years: Dr. Guerci congratulates former Bayville Mayor Edward Esposito for being Cardiac Rehab’s longest running patient.
The oldest and largest hospital-based cardiac rehabilitation and fitness program in the region, located at The DeMatteis Center of St. Francis Hospital, is celebrating three decades of patient care. The popular program gets more than 60,000 patient visits every year and offers customized exercise and educational programs aimed at reducing our nation’s number one killer–heart disease. Studies have shown that cardiac rehabilitation can help reduce the risk of recurrence of heart attacks and prevent further hardening of the arteries. Director of Cardiac Fitness and Education, Sue Palo, R.N., sees the benefits every day. “A cardiac event can be a highly traumatic experience to patients and their families,” says Palo. “Our goal is to help people step up to better health - physically and psychologically–and that’s where exercise steps in.” Edward Esposito, 83, has been a patient for the program’s entire existence and he is still going strong. The former Mayor of Bayville and former Fire Chief said his doctor recommended that he start exercising three decades ago because his family had a history of heart disease. “It’s changed my life. I couldn’t imagine a week without it,” says Esposito. The program also has its social benefits. Ed met his wife, Sheila, there and the couple donated a stationary exercise bike as a token of their appreciation. They are looking forward to the program's next anniversary.
Staff News Medical Staff Appointments General Surgery Gary R. Gecelter, M.D. Director of Surgery
Cardiology
A St. Francis Homecoming Retired psychiatric social worker, Larry Green (above with Sr. Pauline Gilmore), received a warm welcome when he came back to visit the Hospital this past September. Larry was 5 years old when he was admitted to St. Francis in 1949, then a sanatorium for children with rheumatic fever, and remained a patient until 1953. Now at the
Richard Shlofmitz, M.D. Director of Cardiology Alan Goldman, M.D. Assistant Director of Cardiology Meyer H. Abittan, M.D. Director, Coronary Care Unit Ari M. Ezratty, M.D. Director of Clinical Research Justine S. Lachmann, M.D. Director of Congestive Heart Failure (previously appointed) Patrick J. Monteleone, M.D. Director of Clinical Education Joseph H. Levine, M.D. Director of Electrophysiology (previously appointed) Thomas Pappas, M.D. Director of Cardiac Catheterization Laboratory George Petrossian, M.D. Director of Interventional Cardiovascular Procedures Nathaniel Reichek, M.D. Director of Non-Invasive Cardiology (previously appointed)
age of 64, Larry is healthy and happy to see the place that was a pivotal part of his childhood. “I have led a normal life and I don’t know if that would have been possible if I did not come to St. Francis,” says Larry. “As an adult, I look back and see that this place saved my life.”
St. Francis Receives New Research Grants to Help Fight Heart Disease
The American Heart Association recently awarded its latest New York state research grants, and researchers at St. Francis received two for their studies of heart disease. Congratulations to the new awardees:
Cardiothoracic and Vascular Surgery Newell Robinson, M.D. Director of Cardiothoracic and Vascular Surgery James R. Taylor, M.D. Assistant Director of Cardiothoracic Surgery & Director of Thoracic Aortic Surgery Harold A. Fernandez, M.D. Director of Heart Failure Surgery Lawrence H. Durban, M.D. Director of Thoracic Surgery Richard Matano, M.D. Chief of Vascular Surgery (previously appointed)
• Madhavi Kadiyala, M.D., who received a $110,000 National Clinical Research
(Previous appointments are included to
Grant to study “Plaque Morphology on Coronary CT Angiography.”
represent the new table of organization.)
• James Goldfarb, Ph.D., who received continued funding for his research on the “Structural and Functional Time Dependent Characteristics of Myocardial Infarction.”
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2009 MarkYourCalendar St. Francis Hospital Events
May 5
The Guild of St. Francis Hospital Spring Luncheon and Fashion Show Americana Manhasset will be sponsoring this popular annual event.
June 1 St. Francis Hospital’s 35th Annual Golf Classic at Meadow Brook Club, The Creek and Nassau Country Club Men, women and foursomes are welcome. Golf reservations will be assigned on a first come, first served basis.
For more information or tickets, call (516) 705-6655
St. Francis Hospital The Heart Center ® 100 Port Washington Boulevard Roslyn, New York 11576 www.stfrancisheartcenter.com
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