A Full Range of Diagnostic and Treatment Options
Penn Medicine offers a full range of diagnostic and treatment options for coronary artery disease, including:
Sophisticated diagnostic capabilities such as:
- CT, MRI, and PET imaging.
- A full range of noninvasive tests.
- Diagnostic catheterization including specialized tests not always available elsewhere, including:
- Fractional flow reserve (FFR) measurement – to accurately choose whether angioplasty and stenting or medical treatment is best for "intermediate" blockages.
- Intravascular ultrasound (IVUS) – to aid in the selection and sizing of stents and balloons and confirm that a stent has been perfectly placed.
Treatment options such as:
- Comprehensive lipid (cholesterol) management to slow disease progression.
- Medications to control symptoms.
- Interventional procedures such as angioplasty, with or without stent placement, to reduce the need for surgery while providing better results than medication alone.
- Coronary artery bypass grafting (CABG).
Hybrid Revascularizations in Penn's Hybrid OR/Cath Labs
Originating in a partnership between cardiovascular surgeons and interventional cardiologists the hybrid OR/cath labs introduced a new way of treating cardiovascular disease based on the concept of performing endovascular aortic and transcatheter aortic valve interventions sequentially in the same space.
An increasing number of hybrid coronary revascularization procedures are being performed in the hybrid OR/cath labs at Penn. These procedures combine off-pump minimally invasive CABG with concomitant percutaneous coronary interventions (PCIs) to achieve complete revascularization for high-risk patients with coronary artery disease. Advantages include minimally invasive incisions, shorter ICU and hospital stays and an earlier return to satisfactory quality of life.
Other surgeries performed in the hybrid OR/cath labs at Penn include concomitant minimally invasive valve repair/replacement, coronary surgery, and complex hybrid thoracic aortic surgery combining conventional open aortic repair with endovascular stent graft therapy.
Coronary artery bypass procedures
Penn is a leader in innovative approaches to coronary artery bypass grafting (CABG) for the treatment of high-risk patients with cardiovascular disease.
Off-pump CABG Procedures
Cardiopulmonary bypass (CPB) is identified with a variety of potential complications, including hemolysis and vascular damage. Off-pump CABG procedures avoid CPB and have a number of reported benefits, including reduced average postoperative hospital stay, fewer blood transfusions and quicker recovery. At Penn, W. Clark Hargrove III, MD now performs the majority of CABG surgeries as off-pump procedures.
All Arterial Aortic “No–Touch” Off–Pump CABG
Cardiovascular surgeons at Penn are performing all arterial "no-touch" off-pump CABG, which is especially useful for patients with cerebrovascular disease, carotid disease, atherosclerosis and other comorbidities. The benefits of this procedure include long-term graft patency, a reduced risk of stroke and revascularization equivalent to standard CABG procedures.
Induction of therapeutic hypothermia has lead to doubling of survival for cardiac arrest (CA) patients.
A multidisciplinary team at Penn has developed a highly successful therapeutic hypothermia program for immediate survivors of CA. A treatment in the critical care setting, therapeutic hypothermia is based on the careful reduction of core body temperature to 33º C (91.4° F) for 24 hours and goal-directed hemodynamic management. When initiated within hours after initial resuscitation from CA, therapeutic hypothermia has been shown to produce remarkable neurologic recovery.
Therapeutic hypothermia is offered by the post-arrest care program at Penn, a team comprised of internationally recognized cardiologists, critical care and emergency physicians and nurses. This team developed the Hypothermia Training Institute at Penn, a novel course tailored to providers throughout the United States. The program partners with PennSTAR.