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Advances in Coronary Bypass Surgery - An Interview with VM Chairman and CEO Gary Kaplan, MD
- Sky Radio, which provides audio programming for major airlines recently interviewed Virginia Mason Chairman and CEO Gary Kaplan, MD as part of their “Best Hospitals in America” program. Dr. Kaplan spoke on new advances in treating coronary artery disease and performing bypass surgery. Listen to the broadcast or read the text of the interview below. Host: Dr. Gary S. Kaplan is Chairman and CEO of Virginia Mason Medical Center in Seattle, Washington. Dr. Kaplan says that despite the positive life-style changes we Americans have been making, heart disease still affects more than sixty-two million of us. Heart disease encompasses many heart problems, but the most common is coronary artery disease. We’re going to talk today about coronary bypass, a surgical procedure that has saved the lives of many, many people with coronary artery disease. Dr. Kaplan, welcome to Sky Radio. Dr. Kaplan: Thank you, nice to be here. Host: Now Dr. Kaplan, Virginia Mason was the first hospital in Seattle to adopt endoscopic vein harvesting as the standard of care for all bypass surgery patients. Will you explain to us in layman’s terms what this is and what the benefits are to the patients? Dr. Kaplan: Most coronary artery bypass operations have traditionally required the use of a vein from one of the legs, and previously long leg incisions have been used to remove these veins, and unfortunately, the result is often significant postoperative pain, healing complications and significant scarring. Now we use two or three very small incisions – each one less than an inch – and the veins are removed with an endoscope that is placed beneath the skin. The result is now excellent outcomes, less pain, quicker return of our patients to normal leg function and a superb cosmetic result as well. Host: Wow, that is absolutely amazing. I’d also like to ask about what is known as the off pump coronary bypass operation. What does this mean and why are more and more surgeons using this technique? Dr. Kaplan: Off-pump surgery, which is often now called, beating-heart surgery, involves not stopping the heart and not placing the patient on a heart-lung machine. Instead, we stabilize small areas of the heart so that it can continue to pump blood to the rest of the body while the bypasses are constructed as part of the surgery. Here at Virginia Mason, all four of our cardiothoracic surgeons perform this beating-heart surgery routinely, and this gives them by far the most experience in Seattle. In 2001, we began to perform more than half of our coronary bypass procedures off the pump and today we’re currently performing more than eighty percent of our surgeries off pump, compared with a nationwide figure of less than thirty percent. What this offers our patients are a number of benefits over the traditional on-pump procedures. Patients recover quicker, their cognitive function is preserved, they have shorter hospital stays and much fewer major complications such as stroke and infection. Host: Wow, that is very interesting, and finally Dr. Kaplan, what can we expect to see in the next five to ten years in the prevention and care of coronary artery disease? Dr. Kaplan: There will be advancements in the management of active disease, particularly in the area of gene therapy around vascular disease, and in all likelihood congestive heart failure as well. There will be new devices such as specialized pacemakers, implantable pumps and this will help our patients remain even more active. But probably the biggest impact an integrated health care system like Virginia Mason can have is in the area of disease prevention. Frankly, I think the American public is probably going in the wrong direction. As you know, we have an epidemic of obesity and obesity related diabetes going on, even in adolescents today. So earlier focus on individual and family risk factors through efforts like what we have here, which we call the Comprehensive Risk Assessment program. These efforts will allow clinicians to help our patients modify their lifestyle and hopefully reduce the likelihood of developing coronary artery disease. Host: Well, thank you for sharing that valuable information. Dr. Gary S. Kaplan is Chairman and CEO of the Virginia Mason Medical Center in Seattle, Washington.