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In the nineteen fifties, under the leadership of Dr. Hugh Fitzpatrick, before the onset of surgical management for coronary disease, the program at St.Luke's-Roosevelt Hospital performed the earliest repairs for a variety of congenital cardiac disorders -- ventricular and atrial septal defects, tetralogy of Fallot, and patent ductus arteriosus, amongst others. Adult surgery consisted mostly of valve replacement procedures. St.Lukes Hospital was one of only a handful in the entire United States performing such procedures and indeed in the whole world. Our reputation as a center of excellence and compassionate care drew patients from around the world.
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During the nineteen sixties, with the advent of coronary arteriography, first performed at the Cleveland Clinic by Dr. Sones, the managers of St. Luke's Hospital made a bold decision to expand the cardiac services and recruited Dr. Harvey Kemp to head the division of Cardiology. For the first time, New York City had quality coronary angiography. With Dr. Kemp's help, the managers then recruited Dr. John Hutchinson and Dr. George Green to initiate a coronary bypass program at the Hospital. At the Roosevelt site, Dr. Chin Bor Yeoh developed one of the other few cardiac surgical programs in New York City at that time.
Dr.
George Green perfected the technique for the use of the internal mammary
artery as a conduit for coronary artery bypass surgery. By utilizing high
magnification via an operating microscope, and absolute perfect anastamoses
or joint could be created between the relatively small internal mammary
artery(IMA) and the even smaller coronary artery. Critics considered the
flow reserve of this kind of graft as inadequate and the technique too difficult
compared with a saphenous vein Ç the method popularized by the Cleveland
Clinic. But Dr. Green persisted, and with exhaustive clinical follow-up
studies, proved the superiority of the IMA. In fact, a 1983 study demonstrated
a long-term patency rate of 94% for Dr. Green's IMA grafts compared with
only 50% for the saphenous vein grafts during the same follow-up period.*
Numerous studies, both before and subsequent, further documented not only
improved patency of the grafts but improved freedom from chest pain, freedom
from reintervention and patient survival. The Internal Mammary Artery was
proven and accepted as the superior technique for coronary artery revascularization.
More recently, the operating microscope was also finally confirmed as an
independent predictor of operative success and improved patient survival
when used for coronary artery surgery in a report published by the New England
Journal of Medicine.* During the 1970's the cardiac surgical service at
St. Luke's Hospital became the largest in the northeastern United States,
performing almost 1500 procedures annually. The program at the Roosevelt
Hospital was moved to the St. Lukes' site in 1981, shortly after the two
hospitals merged. Throughout the 1980's and 1990's studies conducted at St. Lukes/Roosevelt Hospital by Dr. Airlie Cameron reaffirmed the superiority of the Internal Mammary Artery and further showed the additional benefits from the use of both IMA grafts as compared to the use of the single left IMA.* The use of a single left IMA graft persists as the most common type of coronary artery bypass procedure at most centers nationwide (the remaining grafts constructed using saphenous vein) despite the overwhelming evidence to the contrary.
In
2001, Dr. Daniel G. Swistel was appointed chief of the Division of Cardiac
Surgery by Dr. George Todd, chairman of the department of General Surgery.
Dr. Swistel, who trained under Dr. Green, has further expanded on the use
of the Internal Mammary Artery and has perfected the technique of not only
using both IMA's, but grafting multiple coronary arteries with both these
vessels. In most instances, triple, quadruple and even quintuple bypass
procedures are performed using only the IMA's, with the aid of the operating
microscope. Dr. Swistel has sustained the outstanding tradition of coronary
artery surgery at St. Luke's-Roosevelt Hospital and continues to achieve
results such as those that made both Dr. Green and our institution ideals
to which others were compared. In the tradition of our "state of the art" care, the cardiac division, under the direction of Dr. Swistel, carried out some of the earliest "off-pump" coronary bypass procedures and now regularly uses this technology with both IMA's and the operating microscope. Mitral valve repair procedures are the most common type of interventions on that valve and both the mitral and aortic valves are repaired or replaced when necessary with minimally invasive technology through incisions only a couple of inches long and without splitting the breast bone. The division also includes a center for the management of Hypertrophic Cardiomyopathy,(link) one of only a few nationwide, and a center for Bloodless Cardiac Surgery.
In early 2002, Dr. Joseph J. DeRose was recruited to the division. An accomplished cardiac surgeon with a specific interest in the newly emerging field of robotic surgery, Dr. DeRose was appointed Director of Robotic and Minimally Invasive Cardiac Surgery. The Heart Center of Continuum Health Partners (our umbrella organization) was the second institution in the United States to acquire the Intuitive Robotic System. Dr. DeRose was the first surgeon in this country to perform a completely robotic biventricular pacemaker procedure and is involved in major clinical trials to expand the use of robotic technology to many other cardiac surgical procedures including atrial septal defect repair, mitral valve repair and coronary artery bypass.
The division of Cardiac Surgery at St. Luke's - Roosevelt Hospital is proud to continue its reputation as a leader in research, "state of the art technology" and compassionate care.