With four specialty centers within the Pilla Heart Center, six cardiac catheterization laboratories, and a hybrid operating room, Abington provides the right setting for your cardiac care. Working together, cardiologists and cardiothoracic and vascular surgeons coordinate a range of services that best meets your heart care needs.
Although medications may help with atrial fibrillation (“a-fib”) and other types of arrhythmia or irregular heartbeat, sometimes those medicines are not able to control the condition. Minimally invasive cardiac ablation therapies can treat and often cure these heart rhythm disorders.
Cardiologists from the Pilla Heart Center and Heart Rhythm Center, specially trained in electrophysiology, conduct ablation procedures in a dedicated laboratory equipped with the latest technology.
Ablation treatment uses heat from specialized lasers or radiowave (radiofrequency) energy to seal the source of the rhythm problem and quiet overactive nerve stimulation.
The heart’s pulmonary veins often are treated during ablation therapy because they are the most common origin of erratic heart impulses. During the procedure, the pulmonary veins are isolated and neutralized with ablation techniques.
For expertise on ablation therapies, contact the specialists at Abington’s Pilla Heart Center, including the Heart Rhythm Center and Cardiothoracic Surgery.
Angioplasty (with or without Stent)
When arteries become narrowed or clogged, angioplasty can open the vessels and restore good blood flow. This minimally invasive procedure, conducted by Pilla Heart Center specialists in the cardiac catheterization laboratory, treats coronary artery disease, heart attack or myocardial infarction, peripheral artery disease (PAD) and other heart-related problems. Angioplasty is often used to open clogged arteries due to the cholesterol plaque build-up of atherosclerosis, or hardening of the arteries.
During angioplasty, a thin, flexible catheter with a balloon tip is guided into the blockage. The balloon tip then inflates, opening the vessel and allowing blood to flow. Because of this special tip, the procedure is sometimes called “balloon angioplasty.”
A wire mesh stent (small tube) also may be inserted to support the artery walls and help keep them from narrowing. Some stents are drug-eluted, or coated with medication, to help maintain the free flow of blood. Whether an angioplasty patient receives a stent, and whether the stent used is drug-eluting, depends upon specific medical criteria.
For expertise on angioplasty, contact the specialists at Abington’s Pilla Heart Center, Blank Vascular Center, Heart Rhythm Center, Cardiac Surgery and Comprehensive Heart Failure Program.
Aortic Valve Bypass (AVB)
Patients with aortic valve stenosis, a narrowing or stiffening of the aortic heart valve, are often considered for valve repair or replacement because the condition can be deadly. Yet some patients are not good candidates for valve surgery due to scar tissue from previous cardiac surgeries and other reasons.
Aortic valve bypass, or AVB, a minimally invasive procedures, uses synthetic fabric tubing containing a replacement valve to bypass the diseased valve. This method gives the patient a new valve and better blood flow without open surgery or the use of a heart-lung machine. The Porter Institute for Valvular Heart Disease is one of only a few centers in the U.S. performing aortic valve bypass.
For expertise on aortic valve bypass, contact the specialists at Abington’s Pilla Heart Center, including the Porter Institute for Valvular Heart Disease and Cardiothoracic Surgery.
Aquapheresis (Ultrafiltration of Blood)
In heart failure patients, salt and water can build up in the body. Serious complications may develop from this fluid build-up, including swelling, weight gain, and shortness of breath from lung congestion. Patients with these problems often require hospitalization. This happens because their organs, already under stress from the decreased blood flow of heart failure, are further strained by the added fluidic pressure.
Aquapheresis is an ultrafiltration method of removing excess water and salt from the blood. The Comprehensive Heart Failure Program team uses the special aquapheresis technology of the Aquadex FlexFlow system® to monitor and remove fluid build-up in patients with congestive heart failure. The filtered blood is then safely reintroduced into the patient’s body within a minute.
Patients are monitored by Pilla Heart Center cardiologists and advanced medical professionals throughout the process. Electrolyte balance is maintained throughout the therapy. Treatment duration depends on the patient’s condition, but the average length of the procedure is 24 hours. Patients may begin to feel better immediately, or gradually experience lessening of symptoms in accordance with the severity of their conditions.
Aquapheresis therapy restores fluid balance, helping patients feel better and possibly be discharged faster. The Comprehensive Heart Failure Program has offered this therapy since 2009 and has seen fewer readmissions and greater improvement in overall quality of life for our patients.
Read about a congestive heart failure patient who was treated with aquapheresis therapy.
For expertise on aquapheresis, contact the specialists at Abington’s Pilla Heart Center and Comprehensive Heart Failure Program.
Cardiac catheterization is a treatment method as well as a diagnostic test. During cardiac catheterization, specially trained interventional cardiologists guide a thin flexible tube (or catheter) into the heart. This can identify blocked arteries, evaluate the severity of heart valve disease and assess other cardiac conditions. Treatment is delivered through the catheter to the appropriate area.
As a minimally invasive procedure, cardiac catheterization reduces surgical risks and shortens recovery time. Cardiac catheterization is used for:
The highly skilled cardiologists at the Pilla Heart Center perform more than 2,500 cardiac catheterizations each year in six specialized cardiac catheterization laboratories, two of which are dedicated to electrophysiology. These advanced procedure rooms are equipped with the latest in leading-edge cardiac technology.
Cardiac catheterization plays an important role in cardiac emergencies such as heart attacks. When a patient arrives at the Abington Memorial Hospital Emergency Trauma Center, our cardiac/emergency team speeds transport into one of the Pilla Heart Center’s dedicated catheterization suites, located in the same pavilion of the hospital.
In the cardiac catheterization laboratory, our team is able to restore blood flow to the heart (usually by using a balloon angioplasty to open a blocked artery) within minutes. Our "door to balloon" time ranks well above the national benchmark and the American College of Cardiology has recognized us as a leading hospital for “door to balloon” transfer time in from other hospitals.
As a diagnostic test, cardiac catheterization is often performed on patients who have experienced chest pain, or angina. It also may be used to diagnose and assess:
For expertise on cardiac catheterization, contact the specialists at Abington’s Pilla Heart Center including the Porter Institute for Valvular Heart Disease, Cardiothoracic Surgery, and Comprehensive Heart Failure Program.
Cardiac Device Lead Extraction
Special wires, or leads, provide the energy for implanted cardiac pacemakers and cardioverter defibrillators. Sometimes, these leads need to be replaced due to scar tissue, infection, or damage.
Cardiac device lead extractions demand specialized skill. The procedure is not performed at many hospitals. Pilla Heart Center surgeons are expert at these lead extractions. Using the best technology, our specialists are able to determine when lead removal and replacement is needed and perform the procedure skillfully.
For expertise on cardiac device lead extractions, contact the specialists at Abington’s Pilla Heart Center and Heart Rhythm Center.
A well-structured, enjoyable cardiac rehabilitation program can be the key to ensuring good health after a heart attack, coronary angioplasty procedure, open heart surgery or other cardiac care.
At the Pilla Heart Center, we offer cardiac rehabilitation on an inpatient and outpatient basis. For patients recovering from procedures in the hospital, inpatient rehabilitation is available at Abington Memorial Hospital's Rehabilitation Unit. Some patients also will participate in physical therapy and/or occupational therapy during their stay.
Outpatient cardiac rehabilitation is provided by the expert cardiac registered nurses and exercise physiologists at the Abington Fitness Institute in the Abington Health Center – Schilling Campus in Willow Grove. While exercising at this facility, heart patients have their heart rate and rhythm carefully monitored by Abington Fitness Institute staff. This knowledgeable supervision adds to the safety patients feel as they exercise according to an individualized plan developed by the Cardiac Rehabilitation Program.
Many patients in cardiac rehabilitation find it improves their physical functioning and sense of well-being so much that they continue exercising at the Abington Fitness Institute after completing rehabilitation. The facility offers a full range of exercise equipment and classes. Participants enjoy the added confidence of knowing that the Abington Fitness Institute’s trained exercise physiologists can help them build activity level safely. Exercisers learn to monitor their heart rates and periodic blood pressure checks are available.
For expertise on cardiac rehabilitation, contact the specialists at Abington’s Pilla Heart Center.
With dozens of specialists in various fields of cardiovascular disease, cardiology services at the Pilla Heart Center are of the highest quality, making us a cardiac care leader throughout the region. That expertise combines with our leading-edge diagnostic and treatment equipment, collaborative programs for disease management, innovative cardiovascular interventions, and clinical research to keep us on the cutting-edge of therapy advancement.
Our cardiologists excel at interventional procedures such as angioplasty, cardiac catheterization, and other interventional cardiology techniques. They are highly skilled in the diagnostic and treatment uses of electrophysiology, and in conducting echocardiography and other studies.
Cardiology services at the Pilla Heart Center also include cardiac event and 24-hour Holter monitors with EKG (electrocardiogram) technology and implantable loop recorders. Patients wear these monitors at home, pushing a button to record the times they experience symptoms such as dizziness or irregular heartbeat. Our cardiologists evaluate the findings to determine if those episodes are due to heart rhythm disorders.
Through Pilla Heart Center cardiology services, patients may have their heart functioning assessed by exercise and non-exercise stress tests. Our cardiologists conduct these exams to evaluate conditions such as coronary artery disease. The Pilla Heart Center conducts about 3,000 nuclear (type of imaging agent) and non-nuclear stress tests each year.
For expertise on cardiology, contact the specialists at Abington’s Pilla Heart Center, Heart Rhythm Center, and Comprehensive Heart Failure Program.
The words, “You need heart surgery,” can feel overwhelming. The cardiothoracic surgery specialists at the Pilla Heart Center are dedicated to listening to patients and families, explaining leading-edge methods, and providing exceptional, coordinated care.
Our heart surgery program has become a model for others throughout the country. We use a team of specialists with the best strengths and surgical expertise in the chest and heart to achieve excellent outcomes. Our team includes: cardiac and thoracic surgeons, cardiologists, anesthesiologists, advance practice professionals, and pulmonary medicine experts.
The Pilla Heart Center cardiothoracic surgery team has performed thousands of heart procedures. The team is widely recognized for its high-quality knowledge of advanced technological developments and commitment to patient safety. Our experts are proficient in both minimally invasive and open heart surgery. When possible, we use minimally invasive procedures for less trauma to patients, to reduce certain risks, and shorten recovery time. Because of our capabilities and results, we see many patients from throughout the Delaware Valley, as well as beyond.
Our cardiothoracic surgery team has performed more than 3,500 open heart operations.
Each open heart patient is jointly cared for by surgery, cardiology, and pulmonary critical care specialists.
Pilla Heart Center cardiothoracic surgical experts are highly skilled in many of the latest heart surgery techniques, including:
Procedures are performed in special heart surgery operating rooms. These large rooms are designed to accommodate the latest surgical technology as well as a specialized team.
By using minimally invasive procedures when possible, our cardiothoracic surgery specialists reduce blood loss, so patients are less likely to need blood transfusions. For those who wish to avoid exposure to donated blood and blood components, we work with the specialists at the Abington Memorial Hospital Center for Bloodless Medicine and Surgery.
Pilla Heart Center cardiothoracic surgery advanced care practitioners help patients and families with all aspects of preparing for heart surgery, recovery in the hospital, guidance for home care, and life after surgery. Our team includes:
- Cardiac surgery nurse practitioners: These registered nurses (RNs) hold Master of Science or Doctoral degrees in nursing. Our nurse practitioners are licensed and board-certified in acute care to diagnose and manage patients with complex heart surgery procedures, in conjunction with our cardiology and pulmonary specialists.
- Cardiac surgery family liaison: This team member alleviates patients’ concerns about their families by providing comfort, reassurance and help to family members while patients are in surgery and throughout their hospital stay in the Cardiac Surgery Unit.
- Cardiac surgery administrative assistant:Providing guidance during a stressful time, this staffer helps patients navigate scheduling and paperwork complexities as easily as possible.
Watch and hear Rohinton J. Morris, M.D., chief of the Division of Cardiothoracic Surgery at Abington Memorial Hospital, talk about how ventricular assist device (VAD) surgery helps heart failure patients.
For expertise on cardiothoracic surgery, contact the specialists at Abington’s Pilla Heart Center including the Porter Institute for Valvular Heart Disease, Blank Vascular Center, Heart Rhythm Center, and Comprehensive Heart Failure Program.
Cardiovascular Research Studies (Clinical Trials)
Medical treatments, techniques and procedures develop through a long research process. This system evaluates whether innovations offer improvement for patients.
The Pilla Heart Center participates in numerous research studies, also known as clinical research trials. These studies assess how new treatments or approaches work for patients with cardiovascular conditions. Often, a method being tested is available only at the hospitals participating in the clinical trial.
Pilla Heart Center physicians and surgeons serve as the investigators for these studies. There’s also a contact person (usually a nurse) for patient assistance on each trial. Patients who meet the requirements of a study will receive information about it. After reviewing that material and having their questions answered, patients decide if they wish to participate. There is never an obligation to take part in a clinical research trial.
Research studies currently accepting patients, as well as trials now in progress, are listed at the Abington Memorial Hospital Center for Clinical Research.
For expertise on cardiovascular research studies, contact the specialists at Abington’s Pilla Heart Center, including the Porter Institute for Valvular Heart Disease, Heart Rhythm Center, and Cardiothoracic Surgery.
Carotid Artery Stenting and Surgery
Carotid artery disease arises from a blockage in the arteries located on both sides of the neck. The blockage is usually caused by an accumulation of fatty cholesterol deposits, or plaque. This condition can reduce blood supply to the brain, causing a stroke.
Lifestyle changes or medication may improve carotid artery disease. When those treatments aren’t sufficient, minimally invasive angioplasty with stenting may be able to relieve the blockage. During angioplasty, a thin, flexible catheter with a balloon tip is guided into the accumulated plaque. The balloon tip then inflates, opening the vessel and allowing blood to flow. At the same time, a wire mesh stent (small tube) may be inserted to support the artery and help keep it from narrowing.
Vascular surgeons at Blank Vascular Center also perform carotid endarterectomy. This surgery opens the blocked neck artery and uses special microsurgical instruments to remove the obstructing plaque.
For expertise on carotid artery stenting and surgery, contact the specialists at Abington’s Pilla Heart Center and Blank Vascular Center.
Center for Bloodless Medicine and Surgery
Many of the minimally invasive procedures used by Pilla Heart Center physicians and surgeons reduce blood loss, so patients are less likely to need blood transfusions. For patients who specifically wish to avoid exposure to donated blood and blood components during their care, we work with the specialists at the Abington Memorial Hospital Center for Bloodless Medicine and Surgery. This team is highly knowledgeable in advanced blood conservation methods and committed to taking every step possible to avoid the use of blood.
The bloodless medicine team helps with planning for tests, surgery and inpatient care, to document and support patient choices. By having the latest medical technology available, patients wanting bloodless treatment find they are able to receive the highest quality medical and surgical care for heart conditions while also having their wishes understood and respected.
Read a cardiac surgery patient’s story about receiving bloodless surgical and medical treatment at the Pilla Heart Center.
For expertise on bloodless treatment for cardiovascular conditions, contact the specialists at Abington’s Pilla Heart Center.
Comprehensive Heart Failure Program
Specialized treatment and care for improved heart function
When your heart does not pump blood the way it should, you may develop heart failure. This condition, also called congestive heart failure, affects an estimated 5.8 million Americans.
The specialists in the Pilla Heart Center’s Comprehensive Heart Failure Program focus on interventions to slow heart failure disease progression—or even reverse it. We help our patients live fully by providing:
We work as a “special team” in collaboration with your cardiologist and primary care providers. Our goals are to improve and maintain your heart function, reduce your hospital stays, and ensure a seamless continuum of care for your greatest benefit.
The Comprehensive Heart Failure Program team includes cardiologists, electrophysiologists, cardiology nurse practitioners, cardiac nurses, physician’s assistants, social workers, dietitians, and others who specialize in caring for individuals with congestive heart failure.
Your cardiologist or primary care physician, physician’s assistant or nurse practitioner can refer you to the Comprehensive Heart Failure Program. For more information, call 215-481-4100.
Read a heart failure patient’s story about receiving an advanced treatment technique through the Comprehensive Heart Failure Program.
Learn more about diagnosis and treatment in the Comprehensive Heart Failure Program.
To treat varicose veins, lymphedema and chronic venous insufficiency, Blank Vascular Center physicians may prescribe the use of compression therapy. This usually involves wearing special stockings or garments to apply graduated compression on the painful or swollen region. Compression therapy supports better circulation. For venous insufficiency and lymphedema, compression pumps also may be prescribed.
For expertise on compression therapy, contact the specialists at Abington’s Pilla Heart Center and Blank Vascular Center.
Congenital Structural Heart Repair
Some heart abnormalities that exist from birth aren’t diagnosed or treated in childhood. Adults needing congenital structural heart repair find help for these conditions at the Pilla Heart Center. Our surgeons are experienced in repairing many heart defects and abnormalities, including narrowing of the aortic artery (coarctation), tetralogy repair, and closing small holes in the heart.
When possible, these repairs are conducted with minimally invasive procedures.
For expertise on congenital structural heart repair, contact the specialists at Abington’s Pilla Heart Center, including the Porter Institute for Valvular Heart Disease and Cardiothoracic Surgery.
Consultations (second opinions)
Getting a second opinion about your heart condition and treatment plan is important. A consultation with another heart specialist can help you understand your options and feel more confident about your decisions.
This can make a vital difference when you are considering procedures or treatments. It’s also essential to ask if the first doctor and facility have extensive experience with the cardiac procedure being suggested—and if those results have been good. Getting a second opinion from a heart center with more expertise may be crucial for your successful outcome.
A second opinion will often provide you with the latest information on the best approaches to your care, from recent research findings. You may also learn about advanced methods for solving your condition with minimally invasive procedures instead of open surgery.
Some patients hesitate to get a second opinion, worried that if they consult another physician, the first doctor will be insulted. In reality, physicians recognize that second opinions benefit their patients, especially for major conditions such as heart disease. What’s more, your insurer may require that you get a second opinion consultation before undergoing certain cardiac procedures.
At the Pilla Heart Center, we see many patients for second opinions on all types of cardiovascular diagnoses, conditions, treatments, and procedures.
For expertise on second opinion consultations, contact the specialists at Abington’s Pilla Heart Center, including the Porter Institute for Valvular Heart Disease, Heart Rhythm Center, Comprehensive Heart Failure Program, Cardiothoracic Surgery, and Blank Vascular Center.
Coronary Artery Bypass Grafting (CABG)
When the coronary arteries become partially or completely clogged, open surgery may be needed to bypass the blockages and restore oxygen and blood flow to the heart. Coronary artery bypass grafting (CABG) uses a healthy artery or vein to create a passageway around blocked vessels.
Pilla Heart Center surgeons are highly skilled in coronary artery bypass surgery techniques. During the operation, they craft a bypass from a chest wall artery, leg vein, forearm artery or abdominal artery to allow blood flow around a blocked artery or arteries. The heart immediately begins benefiting from the increased oxygen it receives when blood flow is restored.
Coronary artery bypass surgery may be performed with the assistance of a heart-lung machine or off-pump, with the patient’s heart beating on its own.
Read about an emergency heart attack patient who underwent CABG to treat three clogged arteries.
For expertise on coronary artery bypass grafting (CABG), contact the specialists at Abington’s Pilla Heart Center and Cardiothoracic Surgery.
The Pilla Heart Center provides a full range of diagnostic testing to identify and manage heart problems. Some diagnostic techniques may be used to simultaneously treat the patient in a minimally invasive way.
We use the latest technology to make diagnosing the causes of heart disease as precise as possible. Our diagnostic capabilities include:
- Cardiac catheterization
During a cardiac catheterization procedure, specially trained interventional cardiologists guide a thin flexible tube (or catheter) into the heart. This can identify blocked arteries, evaluate the severity of heart valve disease and assess other cardiac conditions.
The cardiologists at the Pilla Heart Center perform more than 2,500 cardiac catheterizations each year in six specialized cardiac catheterization laboratories, two of which are dedicated to electrophysiology. These advanced procedure rooms are equipped with the latest in cardiac technology. Patients benefit from our longstanding expertise in cardiac catheterization and leading-edge treatment capabilities using the technique.
Cardiac catheterization is often performed on patients who have experienced chest pain, or angina. It also may be used to diagnose and assess: heart valve conditions such as aortic stenosis; coronary artery disease; congestive heart failure; cardiomyopathy; and congenital heart defects.
This testing evaluates heart valves, heart size and heart muscle function. Each study using this technology, called an echocardiogram, takes about 20 to 25 minutes in a quiet room. High-frequency sound waves create images of the heart valves opening and closing, showing how the blood flows through the heart chambers. Heart size and efficiency can also be evaluated.
A transthoracic echocardiogram (TTE) is non-invasive and uses color-flow Doppler cardiac ultrasound to create a moving picture of the heart and its functioning.A transesophageal echocardiogram (TEE) produces a highly detailed image by using an ultrasound probe in the esophagus, behind the heart, to identify valve disease or blood clots. This test is conducted under sedation.
Abington Memorial Hospital and the Pilla Heart Center perform more than 11,675 echocardiography procedures annually.
- Electrocardiogram (EKG or ECG)
Perhaps the best-known heart test, electrocardiograms (also called EKGs or ECGs) check heart rhythms by measuring and recording cardiac electrical activity. Abnormal heart rhythms or EKG/ECG results may indicate heart disease, but some problems are not seen on electrocardiograms.
Diagnostic electrophysiology studies (EPS) measure electrical activity within heart muscle cells. The one-to-three hour EPS procedure – performed while the patient is awake, but sedated – involves the insertion of "pacing " catheters into the heart. The results can detect the need for atrial fibrillation intervention or pacemaker electrode replacement.
In addition to EPS, the electrophysiology specialists on the Pilla Heart Center team also are highly skilled in using a minimally invasive, sophisticated cardiac mapping system for rapid diagnosis of any arrhythmia.
Our electrophysiologists use the most up-to-date technology in specially equipped rooms dedicated just for those procedures.
For patients whose symptoms occur on and off, special wearable heart monitors help document heart rhythm disturbances or periods of dizziness or lightheadedness. These cardiac event and 24-hour Holter monitors use EKG technology and implantable loop recorders. The monitors are worn at home to evaluate whether symptoms are due to arrhythmia, or irregular heartbeat.
Blood pressure evaluation during daily activities, instead of seated in a doctor’s office, is also available. This allows blood pressure readings to be monitored and recorded at home over a 24-hour period.
- Stress tests
These evaluations compare the patient’s heart functioning at rest and under controlled stress (such as walking) to evaluate coronary artery disease. For exercise stress tests, echocardiograms are performed before and after a patient reaches the appropriate target heart rate while walking on a treadmill. Exercise stress is increased gradually.
Patients who are unable to exercise receive medications to stimulate heart rate (non-exercise stress test). Changes in heart wall motion can suggest blood flow problems. Blood pressure is also measured. Abnormal stress test findings usually will be followed by other tests.
The Pilla Heart Center offers stress tests using nuclear imaging agents as well as non-nuclear exams. Our facility conducts about 3,000 nuclear and non-nuclear stress tests each year.
For expertise on diagnostics, contact the specialists at Abington’s Pilla Heart Center, including the Porter Institute for Valvular Heart Disease, Blank Vascular Center, Heart Rhythm Center, and Comprehensive Heart Failure Program.
Echocardiography (cardiac ultrasound)
One of a full range of diagnostic tests available at the Pilla Heart Center, echocardiography evaluates heart valves, heart size and heart muscle function.
Each study using this technology, called an echocardiogram, takes about 20 to 25 minutes in a quiet room. High-frequency sound waves create images of the heart valves opening and closing, showing how the blood flows through the heart chambers. Heart size and efficiency can also be evaluated.
Echocardiography tests include:
- Transthoracic Echocardiogram (TTE) – This non-invasive test uses color-flow Doppler cardiac ultrasound to create a moving picture of the heart and its functioning. The picture is much more detailed than an x-ray image and involves no radiation exposure.
- Transesophageal Echocardiography (TEE) – A highly detailed image is produced by using an ultrasound probe in the esophagus, behind the heart, to identify valve disease or blood clots. This test is conducted under sedation.
For expertise on echocardiography, contact the specialists at Abington’s Pilla Heart Center, including the Porter Institute for Valvular Heart Disease, Blank Vascular Center, Heart Rhythm Center, and Comprehensive Heart Failure Program.
Used both as a diagnostic test and a treatment for some conditions, electrophysiology focuses on the heart’s electrical system. The electrophysiology specialists on the Pilla Heart Center team use the most up-to-date technology in specially equipped rooms dedicated just for those procedures.
Diagnostic electrophysiology studies (EPS) measure electrical activity within heart muscle cells. The one-to-three hour EPS procedure -- performed while the patient is awake, but sedated - involves the insertion of "pacing " catheters into the heart. The results can detect the need for atrial fibrillation intervention or pacemaker electrode replacement.
Our electrophysiologists also are highly skilled in using a minimally invasive, sophisticated cardiac mapping system for rapid diagnosis of any arrhythmia. This system enables our team to treat the condition with ablation, by using laser or radio frequency energy to heat-seal the source of the irregular heartbeat. Endovenous ablation therapy uses laser or radio frequency similarly, to close off veins.
Pilla Heart Center electrophysiology specialists also implant cardiac pacemakers and cardioverter defibrillators to anticipate and restore the heart's normal rhythm. Other EPS therapies include replacing pacemaker electrodes (or "leads") to help ensure patient safety. We conduct more than 1,300 electrophysiology procedures annually.
For expertise on electrophysiology, contact the specialists at Abington’s Pilla Heart Center, including the Porter Institute for Valvular Heart Disease, Blank Vascular Center, Heart Rhythm Center, and Comprehensive Heart Failure Program.
Endovascular Aneurysm Repair (EVAR)
This minimally invasive procedure treats aortic aneurysm. In endovascular aneurysm repair, Blank Vascular Center surgeons use small incisions in the groin and work through arteries to reach the aorta.
Using a thin catheter, the vascular surgeons maneuver a three-pronged graft to seal off the damaged area. This keeps the aneurysm from bursting. Self-expanding stents (thin mesh tubes) hold the graft in place.
For expertise on endovascular aneurysm repair, contact the specialists at Abington’s Pilla Heart Center and Blank Vascular Center.
Endovenous Laser Treatment (EVLT)
Using advanced laser technology, endovenous laser treatment is a minimally invasive method for dealing with problematic varicose veins.
Blank Vascular Center surgeons first locate the affected vein through ultrasound, then insert a thin laser fiber into it through a tiny entry point around the knee. Energy from the laser is then directed at the faulty vein and seals off the damaged section.
EVLT leaves no scars and patients may return to light normal activities within a few days.
For expertise on endovenous laser treatment, contact the specialists at Abington’s Pilla Heart Center and Blank Vascular Center.
Heart Emergency and Trauma
In heart emergencies, such as a heart attack, a few minutes can make a big difference. Pilla Heart Center patients benefit from Abington Memorial Hospital’s rooftop helipad, the only Level II Emergency Trauma Center in the county (treating more than 100,000 emergencies annually), and cardiac-related departments designed in a cluster.
When time is crucial for a heart trauma patient, these advantages speed access to the highest quality emergency medical teams, cardiovascular experts, surgical teams and critical care units. Our dedicated elevator bank connects all areas in the hospital’s Toll Pavilion, including the helipad, trauma center, specialized cardiac surgery rooms, patient care units and the Pilla Heart Center.
Even before patient arrival, our emergency/cardiac team receives information from 12-lead EKG transmissions sent by emergency medical personnel. This enables us to work quickly once the patient is at the hospital.
Our team is available 24-7 to perform leading-edge, minimally invasive treatments for patients arriving in emergency situations. Among those therapies: angioplasty, a procedure to open blocked arteries; angioplasty with stents to support artery walls; laser and rotoblator techniques, to grind down fatty deposits in arteries or break up blood clots; ASD/PFO closure for congenital structural heart repair; and hypothermic cardiac arrest therapy, which lowers body temperature to protect the brain and improve neurological function after a heart attack.
Because of our exceptional heart emergency capabilities, we rank well above the national benchmark for quickly restoring blood flow to the heart for patients arriving at the hospital with a heart attack.
For expertise on heart emergency and trauma, contact the specialists at Abington’s Pilla Heart Center.
Heart Home Care
Some cardiac patients require additional home care after being discharged from the hospital. The Comprehensive Heart Failure Program has a special home care service for heart failure patients. Other Pilla Heart Center patients may make arrangements for home care after leaving the hospital in cooperation with our Case Management Department or the hospital's Home Care Department.
For expertise on heart home care, contact the specialists at Abington’s Pilla Heart Centerand Comprehensive Heart Failure Program.
Those whose kidneys cannot filter out wastes from their blood must rely on hemodialysis. Before dialysis can begin, specialists must create an “access” to easily reach large volumes of blood. The Blank Vascular Center works with the Nephrology Department at Abington Memorial Hospital, as well as with outpatient hemodialysis units, to coordinate the care of patients who need dialysis.
Blank Vascular Center doctors perform several different types of hemodialysis access, usually in the arm. All of these methods require a short procedure stay at Abington Memorial Hospital:
- Fistula – This access is made by connecting an artery to a nearby vein. A fistula procedure has to be performed weeks or months before it is needed to help ensure a properly enlarged vein.
- Graft – When a fistula is not possible, this access attaches a man-made tube between an artery and a vein. Grafts can be ready for dialysis in a few weeks.
- Central vein access – If fistulas or grafts are not appropriate, a catheter tube may be inserted into a neck vein to provide access to the bloodstream.
For expertise on hemodialysis access, contact the specialists at Abington’s Pilla Heart Centerand Blank Vascular Center.
Hypothermic Cardiac Arrest Therapy
When someone suffers a heart attack and is resuscitated, that patient’s recovery benefits from treatment that lowers the body temperature by a few degrees. Such hypothermic cardiac arrest therapy reduces swelling and protects the brain.
The Pilla Heart Center and Abington Memorial Hospital’s Emergency Trauma Center use several cooling technologies for this treatment.
Hypothermic cardiac arrest therapy begins as quickly as possible after a heart attack. Because this treatment has been shown to improve neurological function after cardiac arrest, the American Heart Association endorses its use.
For expertise on hypothermic cardiac arrest therapy, contact the specialists at Abington’s Pilla Heart Center.
Implantable Devices (pacemakers, cardioverter defibrillators)
Pacemakers restore normal cardiac rhythm, or pace. They are implanted under the skin and often used for patients whose hearts beat too slowly. The devices also may be used for some patients with atrial fibrillation or irregular heartbeat.
Heart pacemakers may be part of an implantable cardioverter defibrillator, a device that can detect a dangerously rapid heartbeat. The defibrillator returns heart rhythm to normal by use of an electrical shock.
Patients with heart failure may receive a special biventricular pacemaker, to help the chambers of the heart beat together. This allows coordinated and effective heart pumping. The Comprehensive Heart Failure Program has pioneered the use of echocardiography, or cardiac ultrasound, to optimize the resynchronization performance of pacemakers. This supports a beneficial response to heart failure therapy using implanted devices.
Pilla Heart Center specialists are highly skilled in implanting cardiac pacemakers and cardioverter defibrillators to anticipate and restore normal heartbeat. They also have expertise incardiac device lead extraction, when needed. In addition, our cardiologists excel in conducting pacemaker diagnostics, to evaluate implanted devices and check their function.
For expertise on pacemakers and cardiac defibrillators, contact the specialists at Abington’s Pilla Heart Center and Heart Rhythm Center.
Pilla Heart Center patients receive exceptional inpatient care when they need treatment at Abington Memorial Hospital. After cardiac surgery, including open heart procedures and valve repair, patients are brought to the Cardiac Surgery Unit (CSU) on the third floor of the hospital’s Toll Pavilion. This unit features technologically advanced monitoring systems, on-site services, and a highly skilled team with expertise in managing patients after cardiac surgery.
Surgery patients are cared for jointly by board-certified specialists from cardiology and pulmonary/critical care, in addition to their cardiac surgeon. The unit’s heart surgery nurse practitioners are registered nurses (RNs) with graduate degrees in nursing. They are licensed and board-certified in acute care for patients who have undergone complex cardiac surgery procedures.
While patients are in the CSU, they and their loved ones benefit from the services of our cardiac surgery family liaison. This team member provides comfort and help throughout the hospital stay.
The Cardiac Intensive Care Unit (CICU) tends patients who are recovering from heart attack, chest pain (angina), and heart rhythm disorders. With leading-edge technology for 24-hour monitoring of seriously ill heart patients, the CICU is staffed by highly experienced cardiologists and cardiac nurses.
Inpatient care for heart failure patients is provided in a dedicated heart failure unit. This unit offers:
- advanced telemetry, for precise monitoring;
- an expert team of cardiologists and nurse practitioners to optimize heart failure management and therapy;
- highly respected electrophysiology specialists skilled at using leading-edge device therapy for heart failure treatment;
- nursing professionals with specialty training in heart failure care;
- aquapheresis ultrafiltration therapy to relieve fluid build-up problems, lessen symptoms and possibly speed discharge;
- bedside education to assist patients and families in beginning recovery;
- a transition nurse to prepare patients for discharge and connect them with follow-up services.
For expertise on inpatient heart care, contact the specialists at Abington’s Pilla Heart Center, including the Porter Institute for Valvular Heart Disease, Heart Rhythm Center, Cardiothoracic Surgery, and Comprehensive Heart Failure Program.
Pilla Heart Center interventional cardiologists use catheterization procedures to diagnose and treat coronary artery disease, peripheral artery disease, heart valve conditions and congenital heart disease, among other problems. These procedures use a thin, flexible catheter, or tube, to diagnose heart conditions and deliver treatments.
Our interventional cardiologists perform these techniques in our specialized cardiac catheterization laboratory. Methods include:
For both emergency and non-emergency patients, angioplasty opens blocked or narrowed arteries to restore good blood flow to the heart. The catheter used has a special balloon tip to push away fatty deposits, called plaque, that are clogging the artery. This method sometimes is called “balloon angioplasty.”
- Angioplasty with stenting
During the angioplasty procedure, our interventional cardiologists may insert a tiny mesh stent to prevent artery walls from collapsing. The stent may be coated with a slow-release drug to prevent the artery from narrowing again.
- Laser and rotoblator therapy
Our highly skilled interventional cardiologists use tiny instruments equipped with diamond tips, or rotoblators, to grind down plaque that is clogging arteries. If left untreated, the plaque could block an artery or rupture, forming a blood clot that could travel to the heart or brain.
The Pilla Heart Center team also uses energy-producing laser devices to break up certain dangerous blood clots.
- ASD/PFO closure
This technique closes small holes in hearts by using a catheter to place a special fabric implant. Heart tissue then grows over the closure.
- Carotid artery surgery (endarterectomy)
A blockage in the internal carotid artery (located on both sides of the neck) can reduce blood supply to the brain, causing a stroke. Interventional cardiologists at the Pilla Heart Center treat carotid artery disease, or CAD, by maneuvering microsurgical instruments into the neck artery and removing the blockage. A stent may be inserted to keep the artery open.
- Peripheral vascular techniques
The arteries and veins of the circulatory system lead to the legs, kidneys, stomach and feet. These pathways may develop fatty plaque deposits, or atherosclerosis, similar to what may happen in the heart or neck. Our interventional cardiologists treat peripheral blockages with angioplasty to open the vessels, often adding stents to keep the pathways open.
For expertise on interventional cardiology, contact the specialists at Abington’s Pilla Heart Center, including the Porter Institute for Valvular Heart Disease, Blank Vascular Center, Heart Rhythm Center, and Comprehensive Heart Failure Program.
Laser and Rotoblator Therapy
Special procedures conducted in the Pilla Heart Center cardiac catheterization laboratory deliver treatments by using a thin, flexible catheter. Laser and rotoblator therapy may be used in conjunction with coronary angioplasty.
In the laboratory, our interventional cardiologists use tiny instruments equipped with diamond tips, or rotoblators. This grinds down fatty plaque deposits that may be clogging arteries, removing the obstruction. The Pilla Heart Center team also uses energy-producing laser devices to break up certain dangerous blood clots.
For expertise on laser and rotoblator therapy, contact the specialists at Abington’s Pilla Heart Center, including the Heart Rhythm Center, Cardiac Surgery, and Comprehensive Heart Failure Program.
This innovative videoscopic treatment offers a surgical remedy for atrial fibrillation ("a-fib") without opening the chest or stopping the heart. Using micro-Maze techniques, Pilla Heart Center cardiac surgeons gain access to the heart in a minimally invasive way through three one-centimeter "keyhole" incisions on each side of the patient's chest.
Our surgeons conduct Maze surgery with a tiny video camera that helps guide the instruments. With the video assistance, they insert a bendable probe through the side of the chest and around the pulmonary veins. The probe burns tiny "scars" on the heart in a maze-like pattern. These scars creates lesions that block the electrical impulses causing the patient's heart to beat erratically.
Patients are ready to go home from Maze surgery in three to four days as opposed to more than a week for traditional heart surgery.
For expertise on Maze surgery, contact the specialists at Abington’s Pilla Heart Center, including the Heart Rhythm Center, and Cardiothoracic Surgery.
Minimally Invasive Procedures
An increasing number of heart surgeries and procedures are being conducted through minimally invasive methods. With these techniques, physicians use smaller incisions than in traditional open surgery. Special instruments and robotic technology may be used as well.
Patients gain many benefits from minimally invasive procedures, including:
- smaller scars;
- less blood loss;
- less risk of needing blood transfusions;
- low infection risk;
- less pain;
- in valve surgery, avoid cutting the breastbone or using heart-lung machine;
- shorter hospital stay;
- faster recovery time and return to normal activity.
At the Pilla Heart Center, our specialists perform many minimally invasive procedures for complex heart rhythm treatment, bypass surgery, repairing heart defects, heart valve surgery, and vascular surgery. These advanced treatments rely on the latest technology. Some are robotic-assisted procedures.
All minimally invasive procedures are handled by our highly trained and experienced team, whose primary concern is the well-being of our patients. For some patients, open surgery may be a better choice. Our physicians and surgeons talk with every patient about the procedure options.
Our interventional cardiologists are treating life-threatening openings in the wall of the heart without open-heart surgery.
For expertise on minimally invasive procedures, contact the specialists at Abington’s Pilla Heart Center.
Nuclear imaging agents highlight blood flow when viewed with a special camera. These images are used to evaluate cardiac function by detecting blockages or blood distribution problems.
At the Pilla Heart Center, nuclear cardiologists conduct exercise stress tests with nuclear imaging agents to assess blood flow into the heart during activity and at rest. This test helps our team diagnose heart disease and recommend therapies.
For expertise on nuclear cardiology, contact the specialists at Abington’s Pilla Heart Center.
Patient Education and Support
The Pilla Heart Center nursing staff and cardiac nurse educators provide information on subjects related to heart conditions. Our educators help both outpatients and inpatients with resources for disease management, coping, nutrition, and lessening risk factors. Surgical patients also receive education on preparing for surgery and caring for incisions.
Support services available to Pilla Heart Center patients include:
- Cardiac support group
This free group meets monthly for heart disease patients and their family members who wish to share their concerns and experiences with others. The group is coordinated through Cardiac Rehabilitation.
- Van service
Patients coming to the Pilla Heart Center for outpatient hospital services may schedule van transportation for a nominal charge. Please schedule at least 24 hours in advance by calling 215-481-4845.
- Transportation and lodging information
For patients and their families who live outside the immediate area, the Patient Relations Department, 215-481-2499, can provide information about transportation options, hotel accommodations and car rentals.
- Pastoral care
For hospitalized patients and their families in need of spiritual, emotional or ethical care, the pastoral care staff is available 24 hours a day. Chaplains in the program provide interfaith ministry with compassionate and respectful understanding. For information, call 215-481-2700.
For expertise on patient education and support, contact the specialists at Abington’s Pilla Heart Center, including the Porter Institute for Valvular Heart Disease, Blank Vascular Center, Heart Rhythm Center, and Comprehensive Heart Failure Program.
- Change of Heart Program
This innovative and positive approach to cardiovascular health combines lifestyle discussions with a Pilla Heart Center cardiologist, consultations with a registered dietitian and an exercise physiologist, and training in stress reduction techniques. These key elements create a holistic and supportive system for success in taking charge of your heart health.
Under the direction of cardiologist David J. Becker, M.D., the 10-week preventive program includes weekly discussions with Dr. Becker on heart-healthy living, nutritional counseling for enjoying a modified Mediterranean diet, ways to increase physical activity easily and safely, and guidance for lowering stress and its effects.
The Change of Heart Program is open to anyone with a family history of heart disease, or who has risk factors such as high cholesterol. Others eligible to register include those who have had a heart attack or have been told they need cardiac intervention or bypass surgery and wish to avoid having the procedure.
- Nutrition Counseling
Healthy eating can help prevent heart disease, support recovery from illness, and prevent complications associated with pre-existing conditions such as diabetes or high blood pressure. Good nutrition also helps you control your weight, increase energy, and enhance your sense of well-being. Yet finding a reliable source for heart-healthy food guidance often may seem difficult.
Pilla Heart Center patients can learn to eat well for life through the Nutrition Counseling Center at Abington Memorial Hospital. The program’s registered dietitians provide practical skills and resources, from nutritional guidance to food selection and preparation tips. If you need to lose or gain weight, reduce cholesterol and fat in your diet, or have a chronic disease which requires diet modification, the Nutrition Counseling Center can help you.
Counseling options include a one-hour session or a more in-depth three-session program. You will receive a full assessment of your nutritional needs and a personal nutrition plan designed to meet your goals. An eight-session weight control program provides help for designing a lifetime of good nutrition and achieving healthy weight.
These nutrition counseling services may be covered by insurance. For information or to make an appointment, call 215-481-2745.
- Start! Walking
Walking helps you take an important step toward a healthier lifestyle. Through the American Heart Association’s Start! Walking program, Pilla Heart Center patients have the benefit of a heart-healthy effort sponsored by Abington Health in both the Abington Memorial Hospital and Lansdale Hospital communities.
- Community Education & Special Events
Throughout the year, Abington Health and the Pilla Heart Center hold many public programs for cardiovascular health at community locations. “Wednesdays for Women” features cardiologists speaking about women’s heart health concerns. “Cooking With the Docs” offers tips on heart-healthy cooking and meal-planning. Free blood pressure and cholesterol screenings, as well as heart and stroke risk assessments, are available.
For expertise on cardiovascular preventive services, contact the specialists at Abington’s Pilla Heart Center.
Pulmonary Vein Isolation and Ganglion Mapping
Medications to control atrial fibrillation, or a-fib, may lose their effectiveness over time for some patients. Using a special mapping technique, physicians at the Heart Rhythm Center are able to locate the origin of erratic heartbeats and perform a minimally invasive procedure to neutralize overactive nerves.
Ganglion mapping tests for the presence of a tangle of nerves, called ganglia, and defines their location. Pulmonary vein isolation, which follows mapping, is a procedure that is percutaneous, or conducted through the skin. In this treatment, Heart Rhythm Center specialists insert a catheter through the pulmonary veins to reach the most common source of atrial fibrillation problems. The veins are isolated and neutralized through heat from specialized lasers or radiowave energy. This cauterizing ablation provides a cure for many a-fib patients.
Because it is a minimally invasive procedure, pulmonary vein isolation shortens recovery time. Patients leave the hospital in a few days instead of after a week or longer with traditional open heart surgery.
For expertise on pulmonary vein isolation and ganglion mapping, contact the specialists at Abington’s Pilla Heart Center and Heart Rhythm Center.
Robotic-Assisted Heart Surgery
It sounds a little like science fiction, but robotic surgery is an advanced technique that enables cardiac surgeons to conduct complex procedures with less trauma to patients.
Surgeons at the Pilla Heart Center are specially trained in robotic technology. Robotic-assisted heart surgery produces excellent results with less pain and blood loss, shorter hospital stays, and faster recoveries.
The Pilla Heart Center is one of only a few centers in the Delaware Valley to offer the daVinci® S Surgical System for cardiac surgery. This technology is the newest and most advanced robotic surgical assistant with FDA approval.
The robotic system gives the surgeon a three-dimensional view, similar to traditional surgery but with greater depth perception. Special robotic instruments offer a laparoscopic (minimally invasive) approach, with magnification that is 10 times greater than the human eye. Due to the system’s enhanced detail and precision, the cardiac surgeon is able to work through tiny incisions.
In a robotic-assisted heart procedure, the surgeon views an actual image of the surgical field while operating in real time, using special instruments. The system replicates the surgeon's movements. It never makes any decisions on its own, or performs any maneuver outside of the surgeon's direct control.
Using a robotic system enables greater surgical precision, increased range of motion, improved dexterity, enhanced visualization, and improved access. Those surgical advantages provide patients with less trauma and a quicker return to daily activities.
For expertise on robotic-assisted heart surgery, contact the specialists at Abington’s Pilla Heart Center and Cardiothoracic Surgery.
This specialized aortic heart valve surgery replaces the patient's diseased aortic heart valve with his or her own pulmonary valve. The pulmonary valve is then replaced with a homograft (made from human tissue) pulmonary valve.
Although a Ross procedure is more complicated than a conventional valve replacement, it has long-term benefits. It fosters growth in the pulmonary artery, which makes this a procedure of choice in younger patients.
For expertise on the Ross procedure, contact the specialists at Abington’s Pilla Heart Center, including the Porter Institute for Valvular Heart Disease and Cardiothoracic Surgery.
Spider veins and small varicose veins may be treated nonsurgically by sclerotherapy. In this procedure, a Blank Vascular Center physician injects a chemical solution into the vein. This seals off the area, causing the treated vein to disappear.
For expertise on sclerotherapy, contact the specialists at Abington’s Pilla Heart Centerand Blank Vascular Center.
Exercise and non-exercise stress tests compare the patient’s heart functioning at rest and under controlled stress (such as walking). These exams are used by Pilla Heart Center specialists to evaluate conditions such as coronary artery disease.
In exercise stress tests, echocardiograms are performed before and after a patient reaches the appropriate target heart rate while walking on a treadmill. The exercise stress load is increased gradually. For non-exercise stress tests, patients who are unable to exercise receive medications to stimulate heart rate.
Changes in heart wall motion during stress tests can suggest blood flow problems. Blood pressure is also measured. Abnormal stress test findings usually will be followed by other tests.
The Pilla Heart Center offers nuclear stress tests using nuclear imaging agents, such as dobutamine, as well as non-nuclear exams. Our facility conducts about 3,000 nuclear and non-nuclear stress tests each year.
For expertise on stress tests, contact the specialists at Abington’s Pilla Heart Center, including the Porter Institute for Valvular Heart Disease, Heart Rhythm Center, and Comprehensive Heart Failure Program.
Transcatheter Aortic Valve Replacement – TAVR
TAVR is an innovative valve replacement treatment for aortic stenosis. It delivers a new valve in a minimally invasive way, without removing the faulty valve.
The Porter Institute for Valvular Heart Disease is one of only a few centers in the Philadelphia area with the expertise to perform transcatheter aortic valve replacement.
Candidates for TAVR
Standard valve replacement surgery is a good option for many patients. TAVR, however, is appropriate for those who cannot have valve surgery, including older patients, those at high risk for surgery, or those who were previously not eligible for surgery. TAVR recently won FDA approval.
In TAVR, a catheter, or tube, is threaded from a small incision in the groin or side. The catheter has a balloon tip holding a collapsed replacement valve. When the balloon tip expands, so does the new valve, moving into place. Blood flows after the tip deflates. The process is similar to angioplasty.
TAVR eliminates the need for open-chest surgery or the use of a heart-lung machine.
For expertise on ablation therapies, contact the specialists at Abington’s Pilla Heart Center, including the Heart Rhythm Center and Cardiothoracic Surgery.
Valve Surgery – Repair, Replacement, and Transplant
Each of the four heart valves—mitral, aortic, pulmonary, and tricuspid—plays an important role in regulating blood flow through the heart.
Healthy heart valves are needed for good heart functioning. If valves are leaky, narrowed, orfloppy, surgery for heart valve repair, replacement, or transplant may be necessary.
Heart valve replacement with mechanical valves or ones made from tissue used to be the chief option for a diseased valve. While replacement is still a good treatment for some patients, heart valve repair is now often a better choice for many. Heart valve transplants also are appropriate for certain patients.
At the only hospital-based valve center in the Philadelphia area, the specialists of the Porter Institute for Valvular Heart Disease have broad knowledge and experience in valve surgery. We are committed to using the best techniques for superior patient results, so nearly all valve surgeries are performed as minimally invasive procedures to avoid cutting the breast bone and prevent putting the patient on a heart-lung machine during surgery.
When possible, our valve surgeons repair heart valves rather than replace them with mechanical or tissue valves. Saving a valve through surgical heart valve repair helps the heart function more efficiently. Heart valve repair also improves long-term survival and has a lower risk of causing blood clots or infection. Because there is no replacement valve, tissue rejection is avoided. So, too, is the need to take blood-thinning medication (especially important to women in their childbearing years).
Some of the most common heart valve repair procedures include:
- Mitral valve repair
The mitral heart valve may be abnormal from birth, or become abnormal due to aging or rheumatic heart disease, infection, or a left ventricular dysfunction. These conditions may cause mitral valve leakage (regurgitation), narrowing (stenosis), or a combination of both. At the Porter Institute for Valvular Heart Disease, more than 96% of patients with mitral valve regurgitation, or leakage, undergo successful heart valve repair, compared to a 44.3% national average. Most patients with mitral valve stenosis undergo valve replacement.
- Aortic valve repair
Aortic valve repair is used to correct some aortic heart valve disorders. It is an alternative to replacement. Aortic heart valve repair is performed less often and is more technically difficult than mitral heart valve repair.
Patients needing heart valve replacement choose between mechanical or tissue valves. That decision may depend upon health condition, age, lifestyle, and other factors:
- Mechanical heart valve replacement
These valves are designed to replicate the function of natural valves. In patients with leaky valves, mechanical replacements prevent regurgitation of blood as it pumps through the chambers of the heart. Mechanical valves are stress-tested to last 200 years. These valves can be heard clicking as they function. All mechanical heart valves require lifelong treatment with a blood thinner, such as warfarin. This blood-thinning, or anticoagulation, therapy requires monitoring with monthly blood tests. Currently, the Porter Institute for Valvular Heart Disease is participating in a large, national multi-center research study evaluating the effects of maintaining the newest generation of mechanical valves without anticoagulation therapy.
- Tissue heart valve replacement
Valves created from animal tissue are usually made from cow or pig heart valves or pericardial tissue. The tissue is treated to prevent rejection and calcification, which can stiffen the valve. Tissue valves are quiet. Patients with tissue valves do not need to take blood thinners. Because they are biological, tissue valves wear out. Tissue valves last an average of 15 years before they need replacement.
Some patients may be able to receive valve transplants using human or animal valves:
- Transplant with human heart valves
Homograft heart valves, from human aortas, are also known as human tissue or cadaver heart valves. The benefit of using these valves as transplants is that they pose little or no risk of rejection and patients do not need to take blood thinners. It is believed that the Porter Institute for Valvular Heart Disease has the largest homograft bank on the East Coast.
- Transplant with stentless porcine (pig) heart valves
These aortic heart valve substitutes are also true heart valve transplants. Unlike human heart valves, stentless porcine valves are preserved in gluteraldyhyde and are not living. They have a "heavy" feel which often limits their applicability to large hearts. Longevity for all tissue heart valves remains under investigation, but they can function for 15 to 20 years.
For all valve surgeries, patients at the Porter Institute for Valvular Heart Disease benefit from leading-edge technology and equipment. Our team is specially trained and highly experienced in many advanced surgical techniques, including:
- Heart valve repair and reconstruction
For expertise on valve surgery, contact the specialists at Abington’s Pilla Heart Centerand Porter Institute for Valvular Heart Disease.
Vascular Aortic Repair
Aortic aneurysm may be treated by vascular surgeons using either minimally invasive techniques or open surgery.
In endovascular aneurysm repair, or EVAR, Blank Vascular Center surgeons use small incisions in the groin and work through arteries to reach the aorta. By maneuvering a thin catheter, the surgeons place a three-pronged graft to seal off the damaged area. This keeps the aneurysm from bursting. Self-expanding stents (thin mesh tubes) hold the graft in place.
EVAR is a minimally invasive procedure, so patients may be hospitalized only one to three nights. Recovery is achieved in about two to four weeks.
Open aortic repair is surgery in which the damaged aorta is reached through an incision in the abdomen. Blank Vascular Center surgeons open the aneurysm and remove any blood clots that may have formed. They then sew the three-pronged graft to the aorta, wrap the wall of the aorta around the graft, and stitch the entire wall back together. Sutures or staples keep the incision site closed.
Following open surgery, patients may be hospitalized five or more days. Recovery takes up to three months.
For expertise on vascular aortic repair, contact the specialists at Abington’s Pilla Heart Centerand Blank Vascular Center.
Vascular Bypass Surgery
When blockage in the arteries is too severe for minimally invasive treatment such as angioplasty, Blank Vascular Center surgeons may restore blood flow through open vascular bypass surgery. The bypass, created from a vein or synthetic tube (graft), reroutes blood from above a blockage in an artery to below it.
There are several different types of vascular bypass surgeries. Blank Vascular Center surgeons are highly experienced in each type:
- Aorto-bifemoral bypass
Blood is rerouted from the abdominal aorta to the femoral (thigh) arteries.
- Femoral popliteal bypass
Blood is rerouted from the femoral artery to the popliteal (knee region) artery
- Femoral tibial bypass
Blood is rerouted from the femoral artery to the tibial (lower leg) artery.
For expertise on vascular bypass surgery, contact the specialists at Abington’s Pilla Heart Center and Blank Vascular Center.
The on-site vascular laboratory at the Blank Vascular Center has the most up-to-date equipment for detecting vein and artery conditions through non-invasive testing. Certain treatments also may be provided through the laboratory’s high-quality technology. The Blank Vascular Center laboratory is accredited by the Intersocietal Commission for the Accreditation of Vascular Laboratories (ICAVL), a key benefit for patient diagnostic and treatment care.
Our specialists use advanced Doppler ultrasound in the vascular laboratory to assess blood flow in arteries and veins. This enables our experts to diagnose peripheral artery disease, vein conditions, and other vascular problems. Carotid artery disease is identified by rumbling sounds in restricted vessels, with the diagnosis confirmed by a carotid ultrasound, CT angiogram, MRI, or cerebral angiogram.
The vascular laboratory’s sophisticated technology helps Blank Vascular Center experts conduct minimally invasive procedures, resulting in fewer complications for patients and quicker recoveries. These techniques include:
- angioplasty to relieve blockage in an artery, used in treating peripheral artery disease, carotid artery disease and other conditions;
- stent placement after angioplasty (to keep the artery open);
- endovascular aneurysm repair or EVAR for treating aortic aneurysms;
- endovenous laser treatment or EVLT to seal off varicose veins with laser energy.
For expertise on testing and treating artery and vein conditions, contact the specialists at Abington’s Pilla Heart Center and Blank Vascular Center.
Vascular Surgery (veins and arteries)
At the Blank Vascular Center, board-certified vascular surgeons and a dedicated vascular surgery team specialize in using the latest techniques to treat vein and artery conditions. They are highly skilled in open surgery as well as less invasive methods.
To treat aortic aneurysm, our vascular surgeons may insert grafts, or synthetic tubes, into the aorta through open surgery. This repair enables Blank Vascular Center surgeons to open the aneurysm, remove any blood clots that may have formed, and sew the graft to the aorta.
When arteries are too severely blocked with fatty deposits, or plaque, for minimally invasive treatment, open vascular bypass surgery will be considered. Bypass surgery re-routes blood flow from above a blockage in an artery to below it. Usually a vein is used to create the bypass, but it is sometimes necessary to use a graft.
There are several different types of vascular bypass surgeries. Blank Vascular Center surgeons are highly experienced in each type:
- Aorto-bifemoral bypass
Blood is rerouted from the abdominal aorta to the femoral (thigh) arteries.
- Femoral popliteal bypass
Blood is rerouted from the femoral artery to the popliteal (knee region) artery
- Femoral tibial bypass
Blood is rerouted from the femoral artery to the tibial (lower leg) artery.
Our vascular surgeons perform carotid endarterectomy to open a blocked neck artery and remove obstructing plaque.
Vein removal is an outpatient procedure, conducted under anesthesia, for seriously affected varicose veins. It also is used to remedy chronic venous insufficiency.
For expertise on vascular surgery, contact the specialists at Abington’s Pilla Heart Centerand Blank Vascular Center.
Lifestyle adjustments for treating varicose veins, such as elevating the legs and exercising when possible, might not be enough to relieve pressure and pain. The condition of some varicose veins – and the discomfort they cause – may make vein removal appropriate.
Using an outpatient procedure that requires anesthesia, Blank Vascular Center surgeons are able to clamp off a seriously varicose vein. They then remove it in sections or in one piece. Vein removal also may be used to treat chronic venous insufficiency.
For expertise on vein removal, contact the specialists at Abington’s Pilla Heart Center and Blank Vascular Center.
Ventricular Assist Device (VAD )
For some patients whose hearts are not pumping blood sufficiently, even with lifestyle changes, medication or pacemaker use, Pilla Heart Center surgeons may implant a ventricular assist device, or VAD. This mechanical heart device takes blood from the left ventricle of the heart and pumps it through the body.
The Pilla Heart Center has received certification
for advanced Ventricular Assist Device (VAD)
from The Joint Commission.
The VAD, or ventricular assist device, improves blood flow and organ function, helping certain heart failure patients become stronger. This cardiac assist therapy can improve quality of life, a return to daily activities and decrease hospitalizations.
Types of ventricular assist devices:
- Ventricular assist devices (VADs) are used for patients whose heart beat has slowed dangerously. Small battery-powered implanted VAD units let patients waiting for a transplant leave the hospital.
- Intra-aortic balloon pumps temporarily maintain heart function. This implanted thin balloon generates pumping action by inflating and deflating the balloon at certain rates.
Patients receiving a VAD learn to manage the device once they are medically stable. The VAD enables a return to daily activities, with certain restrictions and cautions that must be followed. After VAD implantation, patients work with the treatment team to maintain their health and have regular follow-up appointments.
See LVAD patient information to learn more about the cardiac assist device system and what patients need to know to care for LVADs.
Read more about the Mechanical Cardiac Assist (VAD) Program.
For expertise on ventricular assist devices, contact the specialists at Abington’s Pilla Heart Center, including Cardiothoracic Surgery, and Comprehensive Heart Failure Program.
A heart attack often leaves damage in the left ventricle of the heart. That area becomes scarred, which may change the heart’s shape, weakening blood pumping. It may also affect valve function. This process can eventually lead to heart failure.
Through ventricular remodeling, cardiac surgeons at the Pilla Heart Center are able to rebuild the heart to a healthy size after heart attack. Ventricular remodeling is conducted with the use of a heart-lung machine. Surgeons use a special model to reshape the heart and restore it to good function.
For expertise on ventricular remodeling, contact the specialists at Abington’s Pilla Heart Center, including the Porter Institute for Valvular Heart Disease and Cardiothoracic Surgery.
Wearable Heart Monitors
For patients whose symptoms occur on and off, special wearable heart monitors help document heart rhythm disorders or periods of dizziness or lightheadedness.
These cardiac event and 24-hour Holter monitors use EKG (electrocardiogram) technology and implantable loop recorders. Patients wear the monitor at home, pushing a button to record the times they experience symptoms. The wearable monitors help evaluate whether symptoms are due to arrhythmia, or irregular heartbeat.
Blood pressure evaluation during daily activities, instead of while seated in a doctor’s office, is also available. This allows blood pressure readings to be monitored and recorded at home over a 24-hour period.
For expertise on wearable heart monitors, contact the specialists at Abington’s Pilla Heart Center and Heart Rhythm Center.