VOLUME II, ISSUE 2

I N S I D E T H I S I S S U E

ST. CLAIRS FAMILY BIRTH CENTER

HELP FOR POSTPARTUM DEPRESSION

ASK THE DOCTOR

HEART PATIENT PROFILE

COMMUNITY OUTREACH

NEW PETERS TOWNSHIP OUTPATIENT CENTER

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VOLUME III, ISSUE 1

St. Clair Hospital Cardiovascular Services uses a multidisciplinary team of caregiversto deliver advanced cardiac care that not only rivals the cardiovascular servicesfound at the largest hospitals in Pittsburgh, but those across the country.

This story focuses on four of our interventional cardiologists, heart doctors who

diagnose and treat structural diseases of the heart using cardiac catheterization, where a

thin, flexible tube called a catheter is put into a blood vessel in the wrist, upper thigh, or

neck, and a very fine wire is threaded into the heart. Through the catheter, doctors can

perform diagnostic tests and treatments on the heart. They can also remove clots from

coronary arteries, and insert balloons and stents into an artery to restore heart function.

These four cardiologists and their colleagues treat more heart attack victims with

interventional procedures than any other single hospital in southwestern Pennsylvania,

with outcomes that far exceed national averages.

Moreover, St. Clair cardiologists are widely recognized for superior treatment times

for heart attack victims arriving at our Emergency Department, resulting in better

outcomes than some of the most recognized hospitals in the United States.

The Hospitals ren owned Door-to-Balloon team consistently ranks first for its

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St. Clair Hospital MRI Center is nowhome to the areas most technologicallyadvanced MRI (Magnetic Resonance Imaging)

equipment. The Hospital recently installed a

new state-of-the-art GE Optima 450 wide

bore MRI scanner at the Broughton Road

facility in Bethel Park.

The new MRI is much faster, thereby

decreasing the amount of time it takes to

complete the scan. With the wide bore

opening, the patient experience is greatly

enhanced, especially for those who can

become claustrophobic, says Dr. Donald

Orr, Chairman of the Department of Medical

Imaging. Most importantly, its a very

sophisticated diagnostic tool providing

incomparable imaging results.

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Meet Some of St.Clairs Top Heart DoctorsEART STRONG

LEADING TEC NNOLOGYNew MRI Equipment Arrivesat Bethel Park Facility

SM

DR. JEFFREY FRIEDEL, DR. ADIL WAHEED, DR. JOHN GIROD and DR. RYAN ZUZEK.

Pictured are four members of our interventional cardiology team:

EART STRONGCONTINUED FROM PAGE 1

Door-to-Balloon time, a key measurement in emergency cardiac

care in the treatment of heart attacks. The ideal treatment

time for a heart attack victim is less than 90 minutes from the

time he or she enters the Emergency Department door to the

time an angioplasty balloon is inflated to unblock the artery.

These cutting-edge cardiologists conduct interventional

procedures that are minimally invasiverequiring only small

incisions and a catheterbut have maximum results.

Interventional procedures include right and left heart

catheterizations, coronary stent implants, permanent

pacemaker insertions, diagnostic peripheral angiograms,

peripheral stent insertions, and more.

They perform all of these procedures 24 hours a day,

seven days a week for scheduled and emergency cardiac

care, seamlessly delivered with St. Clair's longtime

reputation for quality, compassionate, personalized care.

Soon, St. Clair will be adding a third suite to its Cath Lab

to accommodate the programs growth and to allow our

cardiologists to conduct more extensive procedures.

Features of the third suite include dual imaging, which

allows the cardiologists to image the heart and circulatory

system without moving patients to another room or position

on the table. The suites larger imaging camera will help

the doctors visualize a wider portion of the abdomen and

legs, reducing the need for additional x-rays and contrast

dye. Enhanced technology and high-definition monitors will

give the cardiologists the sharpest images available in

the industry.

The physicians highlighted in the following stories are

just some of the outstanding St.Clair doctors who deliver

these state-of-the-art cardiovascular procedures, all of

which are designed to help southwestern Pennsylvania

residents prevent, diagnose, treat and recover from

cardiovascular diseases.

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A n e w s u i t e w i l l e x p a n d e l e c t r o p h y s i o l o g y a n d a b l a t i o n ,

Dr.Girod describesintravascular ultrasound orIVUS-guided stenting and FFR, orFractional Flow Reserve, asleading-edge technology.

"IVUS and FFR make assessingblockages much more objectiveand accurate than an angiogram,with better outcomes and a moreaccurate diagnosis," he says.

IVUS is a medical imagingmethod that uses a specially designed catheter with a miniaturizedultrasound probe attached to the end. The other end of thecatheter is attached to ultrasound equipment. The ultrasoundallows cardiologists to see inside the blood vessels of the heart todetermine the amount of plaque built up, which cannot be seen byangiography, an x-ray examination that uses a special dye.

"IVUS improves outcomes by allowing physicians to preciselysize a blood vessel, to pick the size of the stent (small metaltubes used to prop open blocked vessels) for the best "fit"possible, decreasing the risk of complication and renarrowing,"Dr. Girod explains.

He says IVUS can also help determine which patients arevulnerable to heart attacks and sudden death by determining thevolume of plaque hidden in the walls of arteries.

Recent research has revealed that most heart attacks arecaused by plaque within the artery wall and not as a result ofnarrowing in the artery opening.

Dr. Girod says FFR is a technique that accurately measuresblood flow through a narrowed portion of a coronary artery, andgives the cardiologist a clearer picture of the best course oftreatment for a blockage.

FFR takes out the subjectivity by allowing for precisemeasurement in real time of the significance of a specificblockage, he says.

Dr. Girod notes that IVUS and FFR produce volumes of helpfuldata to a cardiologist and its all accomplished through small holesin the skin. Everything we do is percutaneous. So it's notconsidered surgery. It's interventional cardiology."

JOHN (JACK) P. GIROD, D.O.

HOUSECALL ASKED EACH OF THE FOLLOWING INTERVENTIONALCARDIOLOGISTS TO DISCUSS A SPECIFIC PROCEDURE IN DETAIL.

Dr. Girod earned his medical degree at the Philadelphia College ofOsteopathic Medicine. He completed an internal medicine residency atthe Cleveland Clinic, as well as a cardiovascular medicine fellowship andan interventional cardiology fellowship at the University of PittsburghMedical Center. He is board certified in interventional and generalcardiology. Dr. Girod practices with South Hills Cardiology Associates.

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Like his fellow interventionalcardiologists, Dr. Waheed iskeenly focused on staying abreastof andlearningthenewest proceduresin interventional cardiology.

One of the latest procedureshe began performing at St. Clairis the use of the Impella LVAD(Left Ventricular Assist Device).

A minimally invasive device,the Impella 2.5 helps fragile hearts

pump blood out of the heart and through the body. The device isinserted through a small artery puncture and is fed into the leftventricle of the heart. It can pump up to 2.5 liters of blood per minute.

"We are trained in the newer procedures, techniques, and newgeneration devices, including the Impella LVAD, which can supportthe heart in case of left ventricle failure," says Dr. Waheed.

He says this new device revolutionizes heart procedures forpatients whose hearts are often too weak to withstand a cardiaccatheterization proceduresuch as angioplasty, a procedure inwhich a tiny balloon is inflated to clear blockages in cardiac vessels.

Dr. Waheed says St. Clair is one of the first hospitals in thegreater Pittsburgh area to use the Impella device, serving as anotherexample of St. Clair's leading position in heart care.

Dr. Zuzek, who started atSt. Clair in July, is the newestmember of the interventionalcardiology team.

While Dr. Zuzek performscardiac catheterizations, he alsois an expert in diagnosing andtreating peripheral arterialdisease (PAD), which involvesobstruction of large arterieslocated outside of the heart,

primarily in the lower extremities. Claudication (leg weakness from circulation abnormalities) and

pain in the legs frequently are misdiagnosed as arthritis, he says.Thats due, in part, to the fact that about 50 percent of patients withmild forms of PAD do not demonstrate any telltale or obvioussymptoms, which include sores, wounds or ulcers, blue or paleskin tone, diminished hair and nail growth, among others.

Patients suspected of having PAD often undergo a non-invasivetest to determine if blood pressure readings in the ankles are lowerthan that in the arms. If that is the case, its likely there is a blockageor blockages in the arteries that feed blood all the way to the ankles.

That test is often followed by an ultrasound exam to try tonarrow down the location and extent of the blockages. Manypatients with PAD can be treated with medications and anexercise regime