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Innovative Coronary Bypass Technique

Wednesday, March 04, 2009 - Danbury, CT

A Boy Scout leader for decades, Noorddin Meghani of Bethlehem thought he was too young at age 51 to worry about cardiac disease. But that changed when cardiologists at Danbury Hospital gave him the bad news: Two of his arteries were 90 percent clogged and a third artery was 70 percent clogged.

Then came the good news: He was a perfect candidate for a double mammary coronary artery bypass routinely performed by Cary Passik, MD, chief of cardiothoracic surgery at Danbury Hospital, to treat young cardiac patients. The complex procedure involves the use of arteries rather than veins to restore blood flow to the heart—a technique that yields improved long-term results and reduces the risk of needing a second bypass operation or angioplasty in the future.

“I’m fortunate that I didn’t have a heart attack or stroke. My heart was in good condition. I just needed Dr. Passik to re-do the plumbing. The team at Danbury Hospital saved my life,” said Meghani, who underwent bypass surgery within 48 hours of the diagnosis.

Connecticut’s leading cardiac care center

Access to advanced surgical procedures such as bilateral mammary artery bypass surgery is among the many reasons why the Praxair Regional Heart and Vascular Center at Danbury Hospital is ranked first in Connecticut for cardiac surgery and in the top 5 percent of hospitals nationwide for overall clinical excellence by HealthGrades®, a leading independent health care ratings company.

“People ask me why I didn’t go to Yale New Haven Hospital or to a New York hospital. But why should I when Danbury Hospital has the finest physicians? I trusted Dr. Passik from the moment I met him and the team of nurses and specialists at Danbury Hospital was superb,” said Meghani. “I can’t imagine going to any other hospital.”

Understanding double mammary bypass surgery

Dr. Passik frequently and preferentially uses both internal mammary arteries from the chest wall to bypass the most important blocked vessels because arterial bypass grafts are more likely to stay open for much longer than vein grafts. He reserves veins taken via minimally invasive techniques from the patient’s leg for less important blocked coronary arteries. “That means the odds of needing another bypass procedure or angioplasty are far less after double mammary bypass surgery, making this the preferred operation for many younger patients,” he said.

The standard bypass operation generally involves one internal mammary artery and the saphenous vein from the leg. “This procedure, while the standard of care, is an old fashioned operation in many ways,” said Passik. “It’s fine for patients who are 80 years old and have a life expectancy of only 10 to 15 years.” For younger patients, especially those under age 60, the use of both internal mammary arteries yields benefits that last 15 to 25 years. “The chance of a left internal mammary artery being open and flowing well to the vessel in the front of the heart in 10 years is 95 to 98 percent,” he said. “A vein sewn to the same vessel has about a 50 percent chance of being open.”

Even the young are at risk for heart disease 

Meghani’s case underscores the importance of having an annual physical examination and paying attention to symptoms that could indicate the presence of a cardiac problem. Despite a family history of cardiac disease, Meghani ignored the bouts of shortness of breath that were occurring more frequently during hikes with his Boy Scouts troop. “I’d rest for a few minutes and keep going,” he said. “I didn’t think anything of it.”

Fortunately, Meghani’s spouse urged him to visit his primary care physician, who recommended he see a cardiologist for further testing. Meghani turned to Lawrence Fisher, MD, a cardiologist with Cardiac Specialists, PC. A stress test indicated a possible blockage, prompting Dr. Fisher to schedule additional tests, including a coronary angiogram, at the hospital. But the treatment plan changed once the cardiac team discovered the severe blockages required surgical intervention.

Within hours, Dr. Passik was at Meghani’s bedside explaining the advantages of undergoing the double mammary bypass surgery.

“Even though the surgery is more complex and the recovery time is a bit longer, having the double mammary procedure made sense to me because of my age,” said Meghani. “I was willing to invest the time if it meant I could avoid another surgery down the road.”

He received “exceptional care and personalized attention” from the entire hospital team. “They did a wonderful job of keeping me informed and of pampering me, too,” said Meghani. “My scars are healing very well.” His recovery continued at the Marcus Cardiac Rehabilitation Center, which offers a supervised exercise program, nutritional counseling and educational programs. “The staff was very positive and willing to work with me on making realistic lifestyle changes,” he said.

These days, Meghani is back to running his business, the Meghani Insurance Agency in Danbury, and trying hard to exercise daily and maintain a healthy diet. He’s also committed to seeing his cardiologist for follow-up care. Meghani doesn’t anticipate any problems, but if something comes up, he knows where to turn. “Danbury Hospital is there for me,” he said, “no matter how big or how small the issue.”

About Danbury Hospital

Danbury Hospital is a 371-bed regional medical center and university teaching hospital associated with New York Medical College, the Yale University School of Medicine, the Connecticut School of Medicine and Columbia University Medical Center. The hospital provides centers of excellence in cardiovascular services, cancer, weight loss surgery, orthopedics, digestive disorders and radiology. It also offers specialized programs for sleep disorders and asthma management. Medical staff members are board certified in their specialties.

Danbury Hospital is ranked in the top 5 percent of hospitals in the country for overall clinical performance by HealthGrades®, a leading independent health care rating organization. It is the only health care facility in Connecticut ranked among the top 5 percent of hospitals nationwide for overall clinical performance five years in a row.

In the area of cardiac care, Danbury Hospital is ranked number one in Connecticut for cardiac surgery and in the top 5 percent nationally for overall cardiac care by HealthGrades®. This is the second consecutive year for the national award.