January 23, 2007
Wei Zhou, M.D., vascular surgeon; Joseph Huh, M.D., Cardiac Surgery chief; VA Secretary R. James Nicholson, Salwa Shenaq, M.D., Anesthesiology chief; David Berger, M.D., Operative Care Line executive; and Grace Mathur, RN, Operating Room nurse manager cut the ribbon opening a new, state-of-the-art hybrid surgical suite at the DeBakey VA Medical Center.
HOUSTON - On January 19, 2007, Secretary of Veterans Affairs R. James “Jim” Nicholson cut the ribbon opening a new, state-of-the-art hybrid surgical suite at the Michael E. DeBakey VA Medical Center (MEDVAMC).
This new operating room combines endovascular, cardiac catheterization, cardiac surgical, laparoscopic, and radiological capabilities, allowing maximum flexibility and speed in the treatment of patients with even the most complex cardiac and vascular conditions.
“The new operating suite greatly advances the ongoing collaborative work of cardiac and vascular patient care. Our physicians will now be able to provide collaborative clinical care for treating high-risk cases by combining cardiac catheterization and open heart surgery in one setting. This operating room brings the doctors to the patient instead of the patient to the doctors. In addition, we can provide the latest cutting-edge endovascular procedures to our veteran patients to repair their aneurysms or blocked vessels,” says Peter Lin, MD, MEDVAMC Vascular Surgery chief.
The suite combines highly advanced equipment and computer systems; state-of-the-art technology; skilled surgeons, cardiologists, radiologists, and anesthesiologists; and specialized nursing and technical staff to perform complex cases involving two or more major services. With VA’s revolutionary e-technology, surgical team members are able to immediately access and retrieve critical health data and images such as X-rays, Computed Axial Tomography (CAT) scans, and Magnetic Resonance Imaging (MRI) as a procedure progresses.
Using a state-of-the art digital angiography system to reconstruct arteries, physicians can now manipulate images and obtain a better vision of complex anatomy or overlapping blood vessels. This new technology improves decision making during interventional procedures such as placing a stent in a narrowed blood vessel or a stent-graft inside an aortic aneurysm.
The hybrid suite enables less invasive, more accurate, and very precise treatment of cardiac and vascular diseases and conditions. Many veterans with complex aortic aneurysms, for instance, will be able to undergo multiple procedures including open surgical and minimally invasive catheterization procedures utilizing the state-of-the-art imaging technology.
"This endovascular hybrid suite is also equipped with a high-tech laparoscopic imaging system. Because we already have a surgical robotic unit in the operating room, we will be able to offer minimally invasive robotic vascular procedures to our patients. This means instead of a large abdominal incision to repair a blood vessel, we can use a surgical robot guided by a small camera," says Wei Zhou, M.D., MEDVAMC vascular surgeon.
“This is a tremendous opportunity to provide unmatched medical care to patients with serious heart conditions, because we can now provide minimally-invasive cardiac surgical care such as percutaneous heart valve repair by working jointly with our cardiology colleagues. This means rather than performing risky open heart surgery, we can provide collaborative clinical care in repairing a heart valve with little or no surgical incision,” says Joseph Huh, M.D., MEDVAMC Cardiac Surgery chief.
“Two obvious advantages are in the areas of time and space. The patient no longer needs to be moved to a different procedure or operating room to accommodate multiple heart and vascular procedures or surgeries,” said Biykem Bozkurt, M.D., MEDVAMC Cardiology chief.
MEDVAMC is a leader in the treatment of cardiac and vascular disease in the VA health care system. Even with a remarkable increase in cardiac surgery patient volume, the MEDVAMC cardiac surgical service is continually ranked as one of the best programs in the VA, not to mention the nation, for its excellent surgical patient outcome.
In 2006, the MEDVAMC received notification from the National Veterans Affairs Surgical Quality Improvement Program Executive Committee that it has demonstrated consistently low observed-to-expected mortality rates in general surgery, all surgery, and all non-cardiac surgery six years in a row. The MEDVAMC is the only VA facility with this record.
In January 2007, the MEDVAMC received praise from the VA Continuous Improvement in Cardiac Surgery Program (CICSP) for decreasing its already exceptionally low cardiac surgery mortality rate under unique and challenging circumstances. The CICSP report examined a total of 422 cardiac surgery cases performed in a two year time period at the MEDVAMC. From August 29, 2004 to August 28, 2005 with 132 cases, the operative mortality was 3 percent or an observed-to-expected mortality ratio of 0.79. From August 30, 2005 to August 29, 2006 with 290 cases, the operative mortality was 2.8 percent or an observed-to-expected mortality ratio of 0.56.