Innovations in Heart Care at Jefferson

Interventional cardiologist Paul Walinsky, MDAbout a week after Ella’s fourth grandchild – a baby girl – was born, her chest pain became so severe she couldn’t do anything.

The 63-year-old retired IRS worker from South Philadelphia had put off addressing the angina that had been getting worse and worse to focus on the arrival of the new baby and deal with her husband’s health problem.

But the pain became so bad she could no longer ignore it.

“I couldn’t walk up steps,” she says. “In fact, it would wake me up at night, the pain was very severe.”

This wasn’t the first time Ella had experienced heart problems. Seventeen years earlier, she’d needed bypass surgery to divert the blood around a blockage in her heart. The blood vessel used to bypass the blockage in 1995 had become clogged.

Her cardiologist, Steven J. Neirenberg, MD, FACC, a clinical assistant professor of cardiology at Jefferson and on staff at the Heart Center of Philadelphia, referred her to the interventional cardiologists at Jefferson who had recently presented research on a new, safer method of reopening such obstructed bypasses with angioplasty and stents.

Historically, about one in ten of the cases where the bypass vessels are reopened using angioplasty, patients sometimes develop life-threatening complications such as heart attacks and re-blockages that require a second intervention when dislodged plaque or clots cause a new blockage and potentially a heart attack.

The interventional cardiologists at Jefferson, however, found that adding a medication that relaxes blood vessels, in addition to umbrella-like distal protection devices used to capture the dislodged plaque and debris, is more effective at preventing complications than the protection devices alone.

“You are providing protection on two levels,” says Paul Walinsky, MD, the cardiologist who performed Ella’s procedure. “One is the physical level – the filter that captured large pieces of plaque that are dislodged – and the other is pharmacological – the medication that opens up the distal arteries.”

Michael Savage, MD, director of the Cardiac Catheterization Laboratory at Jefferson, presented the team’s research at the Transcatheter Cardiovascular Therapeutics (TCT) conference in Florida in October.

The study examined clinical outcomes 30 days after angioplasty of 163 consecutive patients with prior bypass surgery. Of those patients, 103 were given the medication prior to angioplasty with distal protection devices and 60 underwent the procedures with the devices alone.

“Through the combined power of these two therapies, we have a new approach that is improving outcomes for this high risk subset of patients,” says Dr. Savage.

The day after Ella’s procedure, she was able to go home the next day, the usual course after an uncomplicated angioplasty procedure.

The chest pain was gone and she was ready to hold, and shower with love, her newest granddaughter.

Making an appointment

Please call  1-800-JEFF-NOW  to schedule an appointment with a Jefferson physician. JEFF NOW representatives are available from 8 a.m. to 9 p.m. Monday through Friday.

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