New Heart Center Sets Stage For Advances In Surgical Treatment

For a young heart surgeon with advanced training, the Regional Heart and Vascular Center being built at St Vincent’s Medical Center in Bridgeport presents an exciting opportunity.

“What’s going on here is pretty breathtaking,” said Dr Rafael Squitieri, a cardiovascular surgeon and thoracic surgeon. At 36, the native of Old Greenwich is holding his first clinical appointment.

He comes to St. Vincent’s with training in a host of the latest techniques from Mount Sinai School of Medicine in New York City, after graduating from Greenwich High School and Columbia University. The medical center is planning to maximize his education by providing state-of-the-art facilities in which he and the other surgeons will operate. After completion of the current $50 million renovation phase, the next step will be new intensive care units and operating rooms.

“We will have the most up-to-date physical plant available anywhere in the country,” said Dr Squitieri, “and will be able to grow significantly.”

The new facilities will allow him to use his skills. He is trained in all adult cardiac surgery techniques, as well as esophageal surgery and lung surgery. Dr. Squitieri also received special training in aortic aneurysm surgery during his fellowship at Mount Sinai. “Having the technical expertise in both lung and heart surgery complement each other so well,” he said, “because these two organs function as a unit.”

New surgery suites at St. Vincent’s will be designed specifically for new technologies being developed, he explains, allowing a multidisciplinary approach not available in many hospitals. “Before, operating rooms were considered operating rooms and you couldn’t do anything else in that room,” he explained. “Now they’re open to other specialties and technologies.”

 The latest in magnetic resonance imaging (MRI) technology will be possible, as well as digital imaging of radiology studies, for instance.

“We can then send these images all over the hospital, following the patient from unit to unit, so people taking care of them will have access to a complete record of the patient,” he explained. “It’s a major upgrade for the hospital.”

One of the unique surgeries that might take place in these operating rooms is a new technique Dr Squitieri learned at Mt. Sinai to replace the aortic arch. It involves a major operation to repair the main arteries leading from the heart when they become abnormally large. These dilated blood vessels are called aneurysms. The procedure is highly specialized because doctors put the patient under “deep hypothermic circulatory arrest.”

Dr Squitieri explained that in order to safely operate on the blood vessels, “you have to interrupt the blood flow to the brain. The only way to accomplish that safely is with hypothermia.” The patient’s temperature is drastically lowered, the blood is drained from the body, and doctors have one hour in which to perform the most complex parts of the operation, before putting the patient on a heart-lung machine and warming up the body.

Dr. Squitieri recently participated in the hospital’s first aortic arch replacement, also called an “elephant trunk procedure,” in which the hypothermia technique was used. Surgeons replaced nearly the entire aorta –– the main artery leading away from the heart –– with an artificial graft. Only a few hospitals are doing this specialized procedure routinely, he said.

Techniques now being developed will be possible in the new operating theaters as well, such as robotic techniques that hold promise, and surgical correction of atrial fibrillation, which would control an irregular heart rhythm. “It’s too early to tell what role robotics will have in heart surgery,” Dr Squitieri said, “but we’ll know in a year or two.”

While the technology allows great advances in care, Dr Squitieri is most energized by the complex mechanism within the human body. “Once you see a beating heart, you never lose that feeling of how awesome it is,” he says. “It’s the most rewarding experience to take somebody with a sick heart and give them a better quality of life.”

St Vincent’s Health Services in Bridgeport recently expanded its cardiovascular services and grouped them under the umbrella of the Regional Heart and Vascular Center. Services include 24-hour emergency angioplasty, a state-of-the-art electrophysiology lab, the area’s first cardiac diagnostic and observation center, a comprehensive congestive heart failure program, and a nationally certified cardiac rehabilitation program.

For more information, visit www.stvincents.org or call 1-877-255-SVHS.