With A Talk On Heart Surgery—

Still Practicing Preventative Health, Newtown VNA Turns 90

By Martha Coville

The Visiting Nurses Association of Newtown is celebrating its 90th anniversary keeping with its long tradition of service offering a series of free, monthly preventative health care programs through November.

VNA member Mae Schmidle said that the association was formed during the influenza pandemic in 1918, which killed more people than World War I.

A big part of the VNA’s mission is bringing useful health information to the public, and to that end, the association hosted Dr Cary S. Passik, chief of cardiothoracic surgery at Danbury Hospital, for a breakfast program on the morning of February 2. Dr Passik gave a talk describing surgical treatments for heart disease. Dr Passik specializes in adult cardiothoracic surgery, with an emphasis on the geriatric patient population.

The suffix “thoracic” refers to the thorax, which is essentially the chest cavity. In humans, the thorax includes the ribcage, the 12 thoracic vertebrae to which the ribs are attached, the sternum, and organs such as the lungs and esophagus.

A cardiothoracic surgery is therefore any heart operation requiring that the sternum be cracked, and the ribcage opened. In contrast with cardiovascular surgery, which includes not just heart surgery but also operations performed on arteries and veins throughout the body, cardiothoracic surgery is by definition open heart surgery.

Prior to Dr Passik’s talk, the VNA hosted a buffet breakfast. Members and friends sat at tables laid with cheery red cloths, for heart health month. Ms Schmidle said that Danbury Hospital had recommended Dr Passik. “We coordinated with [Danbury Hospital] to choose the doctor,” she said.

Dr Passik clicked through a slide show he had put together on his laptop. His manner was at once professional and relaxed. He discussed a number of specific heart surgeries in detail, and still managed to provoke laughter from the audience with his humor.

“Even after 20 years [as a heart surgeon], I’m still amazed by the heart,” he said, “and there’s still a lot of mysteries. Things we don’t know.”

His slide show included pictures of healthy, weak, and enlarged hearts. He showed pictures taken during many different surgeries, including operations performed to treat or replace heart valves and bypass surgeries. Some of the photos were not for the weak of heart.

One audience member asked how doctors ascertain whether a bypass surgery has been successful.

“How long do you wait before you close up?” she asked. “How long to you watch the heart to make sure it’s functioning right?”

“Oh, it depends on how busy you are that day,” Dr Passik quipped, adding in a more serious tone “It’s important to be precise, to do it right the first time. ‘Measure twice, cut once.’ Works for carpentry, works for heart surgery.”

While describing mitral valve surgery, performed on the valve separating the left ventricle from the left atrium, Dr Passik returned to the question “how long does it take?” He said, “It’s like Einstein said; you should make things as simple as possible, but not too simple, and I always try to make things as simple as possible, because I find, the more extra steps, the more there is room for error.”

Toward the end of his talk, Dr Passik focused on valve replacements. He showed pictures of surgeons replacing their patient’s aortic valve with those harvested from animals.

“This is a cow valve,” he said. “We have cow valves and pig valves, depending on whether you’re kosher or not.” Of an operation placing a mechanical valve in the heart, he said, “See all these sutures? Don’t try this at home. Professional driver on a closed course.”

The first mechanical valve, he said, was invented in 1960, and only taken off the market last year. When it comes to heart surgery, “We’re very lucky in this country.” He said, “In China, they have knockoffs” of patented mechanical valves, “because people can’t afford the real thing. These valves cost $5,000. In India, they tell you, ‘A valve lasting ten years will cost this much, and a valve lasting five years costs this much.’ You have to choose.”

Another audience member asked how a doctor decides what kind of replacement valve to use.

“Well, it depends on the pathology and how old the patient is,” the doctor replied. “The advantage of the mechanical valve is that you don’t need to take Coumadin [a blood thinner], you can just take aspirin.” Still, as far as the long-term success of particular procedures, he said, “Predictions are very hard to make, particularly those pertaining to the future.”

While valve replacements are fairly easily obtained, at least in the United States, Dr Passik said finding a donor for a heart transplant is more difficult.

“Some patients need a whole new engine,” he said. “It’s hard to do, you know, to find a heart donor, because most people don’t want to drive their motorcycles into trees.” While a patient is waiting for a donor, “an artificial heart can keep you alive for a year or two, while you’re waiting for a transplant.”

More Programs Coming Soon

“This is our second program,” Mae Schmidle said, referring to Dr Passik’s program. “It just happened that we chose heart health because it coordinated this month with women’s health.”

The American Heart Association celebrates February as American Heart Health Month.

“We really know all the topics we want to cover [during the programs],” Ms Schmidle said, “but we haven’t planned them all yet.”

“All of our events are free,” she said. “We’ll have a free cholesterol screening on February 23, at about 10 am. You just have to call to register.” The cholesterol screening will, like Dr Passik’s program, take at Newtown Senior Center, on Riverside Road in Sandy Hook.

There is no charge for the screenings, but registration and fasting prior to being screened are necessary. Residents should call 270-4377 to register.

Next, Ms Schmidle said, the VNA will perform audio screening to check for hearing loss.

“We’ll also do hearing screenings for children. We’re going to be here the first Saturday in March,” she said. Other preventative health programs will be announced as plans are finalized.

Ms Schmidle also mentioned the VNA’s Loan Closet. Residents may borrow wheel chairs, walkers and other durable medical equipment from the Loan Closet at no charge.

“For some reason, we have a lot of walkers right now,” she said.

Call 426-6556 to arrange to borrow equipment.