PinnacleHealth Harnesses Innovation to Ensure Advanced Care

By Philip Guarneschelli, MBA, FACHE, President and CEO, PinnacleHealth System
Thursday, April 20, 2017

As a healthcare administrator for more than 30 years, I have seen dramatic transformations in health care, but the greatest change has been in cardiovascular surgery. Thirty years ago, I would not have believed that most heart surgeries would someday be performed with tiny incisions in the side of the chest or groin. One of the greatest rewards of working at PinnacleHealth has been witnessing firsthand how these advances have helped patients right here in Central Pennsylvania.

Philip Guarneschelli, MBA, FACHE, President and CEO, PinnacleHealth System

For example, Mubashir Mumtaz, MD, FACS, FACC, Chief of Cardiothoracic Surgery at PinnacleHealth, noticed that patients were healing slowly after a full sternotomy. He thought there needed to be a better way, so he visited other surgeons performing minimally invasive surgery and studied their technique.

He noticed, however, that although they were doing less invasive procedures, they were still cutting some bone, cartilage and major muscle groups to get to the heart, causing significant trauma to the body. Therefore, he developed a technique to access the chest cavity with a small incision on the right side of the chest. It used a much smaller opening — about 1 1/2 to 2 inches — to enter the rib space without the need to cut bone or cartilage, while still preserving the major chest muscles. Since he started this technique in 2014 for aortic valve replacement, which he called intercostal surgical aortic valve replacement or iSAVR, he has expanded its use with other valves — mitral, tricuspid, and even two or three valves at a time.

Patients benefit from this minimally invasive intercostal procedure because it is less traumatic, and it does not require cutting ribs, cartilage or the major muscles of the chest. In addition, it preserves the right internal mammary artery. Dr. Mumtaz’s patients experience less trauma, excellent cosmetic results (less scarring), quicker and earlier recovery, less time in the ICU and hospital, and reduced need for blood transfusions.

Dr. Mumtaz’s skill, innovations and dedication to his patients have made him the top valve surgeon in the state of Pennsylvania by volume, according to the recent Pennsylvania Health Care Cost Containment Council’s cardiac surgery report. PinnacleHealth performs more valve surgeries than any other hospital in the state with combined “significantly lower than expected” mortality and readmissions for heart valve surgery.

Outside of the operating room, in the hybrid catheterization lab, our team at PinnacleHealth offers the complete spectrum of therapies that do not require chest incisions. These include transcatheter valves for aortic valve stenosis, beating-heart repair of the mitral valve and beating-heart mitral valve replacement. One unique element of our structural heart program is the team of surgeons and cardiologists who work together and meet every Friday morning to discuss patients so we can provide them the best possible care. Their close partnership helps ensure the highest-quality and most personalized care for our patients.