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2012 Medical Breakthroughs 

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November 2012

Dual Epicardial Endocardial Persistent Atrial Fibrillation (AF) Study (Staged DEEP) Feasibility Trial

Atrial Fibrillation, commonly referred to as simply "AF", is the most common form of irregular heartbeat. Even with many treatment options available, half of AF patients continue to suffer with persistant AF. The Staged DEEP feasibility trial at Sentara Heart Hospital is offering these patients a promising new treatment option.

The Staged DEEP trial is a Food and Drug Administration-approved pilot study sponsored by cardiac device manufacturer, AtriCure, Inc. The study is designed to evaluate the safety and effectiveness of a combined procedure by a cardiothoracic surgeon and a cardiac electrophysiologist (a cardiologist specially trained to evaluate and treat the electrical impulses of the heart.)

Working through tiny incisions in the chest, the surgeon creates surgical lines on the outside of the heart that block electrical impulses. During the same hospital stay, a cardiac electrophysiologist tests the surgical lines and then completes additional ablation lines within the heart using tiny catheters.

Sentara offers a number of services to help patients manage AF, including the Sentara Heart Arrhythmia Center – the region’s first and only center that brings together highly talented cardiothoracic surgeons and cardiac electrophysiologists to diagnose and treat simple to complex AF and other cardiac arrhythmias.

Sentara Heart Hospital is one of only five leading AF Centers of Excellence participating in this FDA trial.

The number of patients with persistent AF is expected to increase significantly due to the progressive nature of the disease and the aging population.October 2012

October 2012

Bronchial Thermoplasty
New Asthma Treatment Has Patients Breathing Easier

People suffering with severe asthma are finding relief with a new, minimally invasive treatment. Sentara Williamsburg Regional Medical Center was the second hospital in the state of Virginia to offer Bronchial Thermoplasty. This promising asthma procedure is now also available for patients at Sentara Virginia Beach General Hospital.

Gaining control over the symptoms of asthma can be challenging for people suffering from this lung disease. Bronchial Thermoplasty was approved by the FDA in 2010 for treating adults over 18 years old with severe asthma.

- The procedure has been clinically proven to demonstrate an improved quality of life for asthma patients.

Benefits for Patients Include:
Fewer asthma attacks
Fewer Emergency Room visits for respiratory symptoms
Fewer days lost from work/school or other activities due to asthma.

This minimally invasive outpatient procedure uses a bronchoscope to deliver thermal energy to the lungs of patients with asthma in order to decrease the amount of smooth muscle in the lungs – the muscles that constrict and result in asthma symptoms. The entire treatment is administered over three visits, each treating a different part of the lungs.

Bronchial Thermoplasty treatments give patients better control over their asthma because the lungs are not able to constrict as much and react as vigorously to asthma triggers.

In addition to decreasing the incidence of asthma symptoms, the procedure also aims to decrease the amount and strength of the medications needed to maintain asthma control.

If you suffer from severe asthma symptoms, talk with your physician about the benefits of this new procedure or call 1-800-SENTARA (1-800-736-8272) for physicians specially trained to perform Bronchial Thermoplasty.

August 2012

Offering Hope for Pancreatic Cancer

A multidisciplinary team of physicians and a nurse navigator in the Sentara Cancer Network collaborate to provide treatment alternatives to patients with pancreatic cancer. 

The pancreas is a complex organ. Stretching horizontally across the abdomen, it plays an integral role in digestion and the endocrine (hormone) system. Whether you’re a man or a
woman, your lifetime risk for developing pancreatic cancer is about one in 71*. A challenge to treat, the diagnosis of pancreatic cancer can be disturbing news.

While not new, the Whipple surgical procedure has been enhanced with new skills in advanced imaging to help to define the tumors more precisely. And improvements in anesthesia help support patient safety during this complex surgery. It remains an important option for surgical treatment of (exocrine) pancreatic cancers that are confined to the head of the pancreas and have not spread to surrounding organs or blood vessels. This complex surgery (also known as a pancreaticoduodenectomy) can last several hours. At the pancreatic conferences, physicians from all disciplines look at CT scans and biopsies in real-time and can discuss each individual case in depth.

- Pancreatic cancer often goes undetected while it grows and spreads before any symptoms appear.

-Twice a month, the Pancreatic Consortium of the Sentara Cancer Network, led by physicians from Eastern Virginia Medical School, Virginia Oncology Associates and Sentara, conducts a Hampton Roads conference to evaluate patients and identify the most beneficial

- Patient survival rates may be extended from a 5% five-year survival rate to a five-year survival rate of 20%.

*American Cancer Society, 2012

July 2012

MIST® Therapy
Healing Wounds From The Inside Out

It may sound a bit odd, but skin is the largest organ of the body. In a healthy person, when the skin is injured, it usually heals on its own without complications. For older people and those with certain health conditions such as diabetes, peripheral vascular disease or other circulation issues, a simple wound may become a chronic wound—one that is difficult to heal.

The gentle action of the saline with the ultrasound waves work to promote wound healing by:
 Reducing inflammation of cells that surround the wound, “awakening” them to a normal healing state. 
 Reducing bacterial cells to increase the healing process. 
 Increasing blood flow to the wound area.

The treatment itself is painless. The patient only feels the cool, gentle mist of the saline as it reduces the pain of the wound. A deep tissue injury (DTI), tissue that is damaged from the inside of the body, like a “bed sore,” can start MIST Therapy treatment before the wound even breaks the surface of the skin. MIST Therapy is currently offered at the Sentara Wound Healing Center at Sentara Obici Hospital. There are many other types of healing treatments available to help wounds that won’t heal. For more information on Sentara Wound Healing Centers in your community, call 1-800-SENTARA (1-800-736-8272) or visit www.sentara.com/woundhealing

May 2012

Skeletal PET/CT Scans
Detecting Cancers In The Bones

The Sentara Cancer Network offers mobile PET/CT technology that has now evolved to allow a full body scan of a person’s skeleton to discover and evaluate any cancer that may have spread to the bones.

It’s an unfortunate fact that sometimes cancer can spread to a different part of the body, including the bones. With the FDA approval of an 18F-Sodium Fluoride radiopharmaceutical injection, PET/CT is now approved for total skeletal scans. PET/CT (Positron Emission Tomography/ Computed Tomography) combines two separate tests to provide physicians with comprehensive diagnostic information. For a Skeletal PET/CT Scan, a small amount of 18F-Sodium Fluoride is put into your body. The fluoride is absorbed into the bone tissues showing bone reaction and blood flow during the PET scan, revealing areas of cancer in the bones. The CT scan is simultaneously performed to mark the exact position of any troublesome area that shows up on the PET scan. This gives your physician vital information to make treatment decisions.

The mobile PET/CT imaging unit visits locations throughout Hampton Roads: Lake
Wright Cancer Center, Sentara BelleHarbour, Sentara CarePlex Hospital, Sentara Greenbrier
Healthplex, Sentara Obici Hospital, Sentara Princess Anne, and Sentara Williamsburg
Regional Medical Center.

A Skeletal PET/CT scan may be ordered for: 
- Staging the spread of cancer to bones at time of diagnosis (e.g., breast, prostate, etc.) 
- Re-staging the spread of cancer (metastases) to bone later 
- Evaluating bone cancer response to chemotherapy or radiation therapy

Patients can appreciate the advantages of Skeletal PET/CT over conventional (nuclear medicine) bone scans: 
-  Greater comfort, 45-60 minutes wait time after radiopharmaceutical injection vs. conventional wait time of up to 3 hours 
-  Shorter scanning times, 30-45 minute scanning time vs. 45-60 minutes 
-  Clearer scanning difference between normal bone (non-cancerous/benign) and cancerous (malignant) bone lesions, for a more accurate diagnosis

April 2012

Total Artificial Heart
A Bridge To Heart Transplant

Sentara Heart Hospital is the first and only facility in our area to offer the SynCardia Total Artificial Heart, a lifesaving bridge to keep the blood pumping and improve the quality of life for heart failure patients awaiting a donor heart transplant.

When heart disease weakens the heart muscles to the point where vital organs – like the kidneys, liver and brain–are not receiving an adequate blood supply, and medical therapy is ineffective, patients have two options to restore their vital blood flow: donor transplantation or a mechanical assist device. The most common device only supports the left ventricle. If both ventricles are failing, the Total Artificial Heart is the only mechanical support option. Approximately 2,200 donor hearts become available each year in the U.S.

Unfortunately, more than 3,000 people are on a waiting list, nearly half (49%), have been waiting for more than a year.* With heart muscle failing and vital organs in jeopardy, patients need to remain hospitalized for continuous intravenous medication. With the Total Artificial Heart implant, crucial blood flow is immediately restored to vital organs, helping the patient to become a better transplant candidate. Initially, the patient is maintained with a large power source or driver. After recovery, an investigational backpack-sized portable driver provides the power for the artificial heart and allows a patient to leave the hospital to lead a more active lifestyle while waiting for a donor heart.

Read more about a Sentara Heart Hospital patient and find out more on this lifesaving medical breakthrough and other Sentara Heart services at www.sentara.com/heart.

*Source: Organ Procurement and Transplantation Network, 03/09/12

February 2012

Aortic Valve Replacement Using A Catheter
Transcatheter Aortic Valve Replacement (TAVR)
Sentara Heart cardiologists and cardiothoracic surgeons at Sentara Heart Hospital have begun offering transcatheter aortic valve replacement (TAVR) therapy with the Edwards SAPIEN Valve. Sentara Heart Hospital is the first heart program in Virginia to offer this non-surgical therapy outside a research study.

The number one cause of death in America is cardiovascular disease.* Aortic stenosis, a deterioration of the heart valve, makes the heart work harder to pump blood. For patients 75 and over who suffer from calcific aortic valve stenosis (where calcium deposits decrease heart blood flow) , it can weaken the heart and lead to heart failure or heart attack. Often, patients may be too frail to undergo open heart surgery to correct this heart condition.

With the transcatheter aortic-valve replacement (TAVR) procedure, Sentara Heart cardiologists and cardiothoracic surgeons are able to perform heart valve replacement through the placement of a collapsible aortic heart valve into the body via a catheter that is inserted through the leg, and threaded up to the heart.

TAVR patients do not require open heart surgery or a heart bypass machine. Recovery is typically one to three days in the hospital. Once home, patients are able to get around better than before the procedure.

This innovative procedure is performed in the region’s only Hybrid Cardiac Operating Suite at Sentara Heart Hospital. This Hybrid OR allows for advanced procedures using cardiac catheterization equipment combined with the amenities of a full service operating room. Sentara Heart cardiologists and cardiothoracic surgeons make up the multidisciplinary team who perform these procedures.

Severe Aortic Stenosis Symptoms:
- Severe shortness of breath
- Chest pain or tightness
- Fainting
- Extreme fatigue
- Lightheadedness/dizziness
- Difficulty exercising 
- Rapid or irregular heartbeat 

To request an appointment or learn more about this and other treatments available at the Sentara Heart Valve and Structural Disease Center, visit sentara.com/heart, call (757) 388-8389 or (877) 261-2225 (toll-free).

 January 2012

Allowing Earlier, Less Invasive Treatments for Cancers Deep Inside the Lungs

Cancer physicians at Sentara Norfolk General Hospital are using Electromagnetic Navigational Bronchoscopy (ENB) to help treat patients with small cancers deep in their lungs.

In recent years, newly developed and improved medical technolo-gies are offering more promising treatment options for people with lung cancers. Once a lung spot is discovered (by x-ray or other imaging), the doctor will need to do further testing to determine if it is cancerous, or benign (non-cancerous). Electromagnetic Navigational Bronchoscopy (ENB) is a new, less invasive option for patients in Hampton Roads.

Like traditional bronchoscopy, ENB uses a thin, flexible tube (catheter) inserted through the mouth to evaluate lung spots. ENB offers the added advantage of a system similar to a GPS that can less invasively locate spots deep in the lungs, where traditional bronchoscopy cannot reach. Without any surgery or incisions, physicians are able to use ENB to identify the cancer stage and develop an earlier treatment plan for mediastinal lymph nodes and lesions.

With ENB, placement markers can be positioned on these lung spots in preparation for CyberKnife incisionless radiosurgical treatments.

The advancements of both ENB and CyberKnife are suitable for a broad range of patients, including those who are too frail or compromised for surgical diagnostic and/or treatment procedures.

For more information on ENB, CyberKnife or other cancer treat-ments, call our Sentara Cancer Network experts at 1-888-220-2214 or visit www.sentara.com/cancer.

- Electromagnetic Navigational Bronchoscopy (ENB) identifies and positions placement markers for lung spots to be treated by CyberKnife.

- CyberKnife is an extremely precise, high-dose radiation treatment delivered directly to the cancer site for selected cancers of the lungs as well as the head, neck, brain, lung, liver, prostate, bone, pancreas and renal system.


Medical Breakthrough Archives:
- 2010
- 2009

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