NYU Cardiothoracic Surgery NYU Medical Center

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                                         NYU Cardiothoracic Surgery
                                         NYU Medical Center




                                         Premier surgical care
                                         for diseases of
                                         the heart and chest
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        From Our Patients:


    •   “I went with NYU
        because it had much
                                                                      •   “[My daughter’s]
                                                                          surgery was
        more experience                                                   performed on a
        with minimally                                                    Monday morning               •   “What words can

        invasive surgery                                                  and Ella was home                convey the undying

        than other                                                        playing in her room              gratitude and

        hospitals… Three                                                  on Wednesday. The                heartfelt affection I

        weeks after my               •   “My visit to NYU                 recovery was so                  have for my doctors
                                                                                                           and nurses? When
        operation, I was                 was most reassuring.             fast… It has taken
        almost 90 percent                [The surgeon] was so             her longer to get                he had coronary

        back to normal,                  engaging and                     over ear infections.”            bypass surgery,

        which was amazing.”              confident, and                         —KIM BROCKWAY              David Letterman
                                         remarkably willing                   mother of Ella (atrial       brought his entire
               —MIKE IONESCU                                                 septal defect surgery)
             (atrial septal defect       to answer every                                                   surgical team to the
                          surgery)
                                         question.”                                                        stage of his late-
                                             —LARRY ANDERSON                                               night show so that
                                             (aortic valve surgery)
                                                                                                           they could be
                                                                                                           applauded. I’d like to
                                                                                                           do that too. Bravo.”
                                                                                                           —LESLIE LIPTON MORELLI
                                                                                                               (mitral valve surgery)
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                                        Welcome to Cardiothoracic Surgery at NYU Medical Center,
                                        one of the nation’s premier facilities for the care of patients
                                        with diseases of the heart and chest. We offer virtually every
                                        treatment option—including the latest minimally invasive
                                        surgical techniques—using an individualized approach that
                                        returns patients to their daily routines as safely, comfortably,
                                        and quickly as possible. Many aspects of minimally invasive
                                        surgery and other innovations in the field were pioneered here
                                        at NYU, and through our research programs, we are actively
                                        pursuing the next generation of therapies. Our expert clinicians,
                                        all of whom are members of NYU School of Medicine’s
                                        Department of Cardiothoracic Surgery, stand ready to help you
                                        with their unique blend of scientific and compassionate care.




                                        Aubrey C. Galloway, MD
                                        Seymour Cohn Professor and Chairman
                                        Department of Cardiothoracic Surgery
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                         WHY CHOOSE US?


                                        Many factors set NYU Cardiothoracic Surgery apart from other
                                        practices, including our multidisciplinary approach to care, our wealth
                                        of experience, our commitment to research, our location in a world-
                                        class medical center, and our dedication to education and outreach. All
                                        told, this unusual combination of knowledge and know-how ensures
                                        that every resource necessary—including the very latest diagnostic
                                        techniques and treatments—is brought to bear on patient care.

                                        Our Approach to Care
                                        Rare among cardiothoracic surgery practices, NYU employs every
                                        significant treatment approach—for example, mitral valve repair as
                                        well as valve replacement, minimally invasive as well as traditional
                                        open-chest procedures, and “off-pump” as well as conventional
                                        arrested-heart techniques.
                                          We maintain such a large treatment repertoire because no single
                                        intervention is ideal for a given condition. At NYU, therapy is tailored
                                        to meet the needs and concerns of the individual patient, rather than
                                        trying to fit the patient to a particular treatment. In crafting a person-
                                        alized plan of care, we rely on our years of experience and on our
                                        one-of-a-kind clinical database, gleaned from the tens of thousands of
                                        patients we have treated over the years.
                                          The majority of our patients are treated with minimally invasive
                                        techniques, allowing us to send patients home as healthy as possible,
                                        and as soon as possible. Compared with conventional approaches,
                                        minimally invasive surgery results in smaller incisions, fewer compli-
                                        cations, fewer blood transfusions, shorter hospital stays, and less
                                        postoperative pain.
                                          Our services and expertise do not begin and end in the O.R. We
                                        strive to provide continuous, coordinated care, starting with your
                                        initial visit to our offices, extending through your stay in the hospital,
                                        your rehabilitation, and your discharge home—providing a full circle of
                                        care for cardiopulmonary health.
                                          We also work to keep you and your family fully informed and
                                        actively involved. Our staff is always available to address your
                                        questions and concerns. One of our nurse practitioners—registered




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       Second Heart,
       Second Chance
       May 12, 2006, was a
       monumental day in Neal
       Bira’s life, but he doesn’t
       remember a second of it.
       Early that fateful day, the
       54-year-old Manhattanite
       suffered a massive heart
       attack—the kind that cardiol-
       ogists call a “widow
       maker”—landing him in a
       medically induced coma for
       two weeks. His wife, Bonnie,
       was told to prepare for the
       worst. He needed a new
       heart, but he wasn’t strong
       enough to withstand a
       transplant. To surmount this
       medical Catch-22, a team of
       cardiac surgeons led by Drs.
       Greg Ribakove and Gregory
       Crooke implanted a left-
       ventricular assist device—
       a partial artificial heart of
       sorts—in Mr. Bira’s chest.
       After two months, he was
       strong enough to go home
       and to be placed on the
       national waiting list for a
       donor heart. “These guys saved
       my life,” says Mr. Bira, referring to
       his NYU doctors. “I’ll never forget it.” On August 13, he was referred for a transplant at a
       regional heart transplant center. “NYU made sure I was in the right hands,” he says. As luck
       would have it, a heart became available 36 hours later. Today, Mr. Bira is on the mend, enjoying
       his second chance at life.




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                                        nurses with advanced education and extensive clinical experience—
                                        will be assigned to work with you every step of the way, arranging
                                        your appointments and tests, coordinating your care plan during your
                                        hospital stay, and preparing you for discharge.

                                        Our Clinical Experience
                                        Another NYU strength is our extensive surgical experience. Studies
                                        have consistently shown that hospitals that perform the highest
                                        volume of surgeries achieve the best outcomes, particularly when
                                                                   complex operations are involved. As the old
                                                                   saying goes, practice makes perfect.
                                                                     Our cardiothoracic surgeons perform
                                                                   about 1,500 operations a year, with some of
                                                                   the highest success and lowest complication
                                                                   rates in the country. We have particular
                                                                   expertise in treating high-risk patients,
                                                                   including infants and seniors (even those in
                                                                   their eighties and nineties) and people with
                                                                   multiple health issues.
                                                                     Our surgical program is built on a long
                                                                   legacy of caring and innovation. NYU
                                                                   Medical Center and Bellevue Hospital
                                                                   Center, its primary clinical affiliate, have
                                                                   stood at the forefront of cardiothoracic care
                                        for decades. In the 1940s, Bellevue cardiologists Drs. Andre Cournand
                                        and Dickinson Richards pioneered the technique of cardiac catheteri-
                                        zation, which transformed the practice of cardiology and earned the
                                        pair the 1956 Nobel Prize in Physiology or Medicine.
                                          In the decades that followed, NYU physicians made key contributions
                                        to the advancement of coronary artery bypass surgery, including the
                                        first use of internal mammary artery grafts (which are taken from the
                                        chest), a significant improvement over a saphenous vein grafts (which
                                        are taken from the leg).
                                          More recently, our surgeons helped refine mitral valve repair—
                                        which has considerable advantages over valve replacement—and then
                                        introduced the procedure nationally. In addition, NYU surgeons were
                                        instrumental in developing techniques for minimally invasive cardiac
                                        surgery. In fact, the world’s first minimally invasive mitral valve repair
                                        and the first minimally invasive triple-bypass surgery were performed
                                        here at NYU.


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                                          Members of our staff also contributed to the development of off-
                                        pump (also called beating-heart) cardiac surgery, which eliminates the
                                        need to place the patient on a heart-lung machine. In 2003, NYU
                                        completed a landmark clinical trial demonstrating numerous benefits
                                        from off-pump bypass surgery in high-risk patients, including a lower risk
                                        of mortality and a lower incidence of stroke and other complications.
                                          NYU’s thoracic surgeons have also made seminal contributions to
                                        minimally invasive surgery, including the use of video-assisted instru-
                                        mentation for removing lung cancers and for treating other conditions
                                        of the chest cavity. These advances have made it possible to perform
                                        surgery on many patients who were once considered inoperable. In
                                        addition, our thoracic surgeons pioneered surgical treatment of
                                        various types of pulmonary metastases (secondary cancers formed by
                                        transmission of cancerous cells from a primary tumor located
                                        elsewhere in the body). They were also among the first to study
                                        photodynamic therapy, a novel treatment for thoracic cancers.

                                        A Commitment to Research
                                        NYU Cardiothoracic Surgery’s tradition of excellence and innovation
                                        is sustained by an extensive program of basic and clinical research.
                                          Recognizing that the ultimate solution to many heart problems rests
                                        at the genetic and molecular levels, NYU’s Department of Cardio-
                                        thoracic Surgery conducts a variety of basic research investigations.
                                        The main focus of this work is a phenomenon called restenosis—the
                                        reclosing of arteries after angioplasty or bypass surgery. Since more
                                        than a million patients undergo these procedures each year,
                                        determining why restenosis happens and how to prevent it is one of
                                        the great challenges of modern-day cardiology.
                                          On the clinical side, our researchers are investigating new
                                        approaches to mitral valve reconstruction, including off-pump repair;
                                        co-leading an international trial on ventricular restoration surgery, a
                                        promising method of treating heart failure; and studying atrioven-
                                        tricular node ablation and pacemaker implantation to treat patients
                                        with a form of arrhythmia known as atrial fibrillation.
                                          Also noteworthy is the Department’s ever-expanding research
                                        database, which we have amassed by following virtually every one of
                                        our patients for life. From this unique store of data, we are constantly
                                        learning better ways to tailor surgery to the individual patient, a
                                        process called risk stratification, which greatly reduces complications
                                        and improves outcomes.


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                                                                           The Race
                                                                           of Her Life
                                                                           Young, healthy, and fit,
                                                                           Marni Baum of Chatham,
                                                                           N.J., was racing through
                                                                           life when a routine
                                                                           checkup revealed a
                                                                           severe case of mitral
                                                                           valve prolapse—a
                                                                           condition in which the
                                                                           valve on the heart’s left
                                                                           side doesn’t close
                                                                           completely, allowing
                                                                           blood to leak backward
                                                                           from the ventricle to the
                                                                           atrium. “It came out of
                                                                           the blue,” recalls the
                                                                           thirty-something mother
                                                                           of twins. “I was asympto-
                                                                           matic, running eight-
                                                                           minute miles at the
                                                                           time.” Ms. Baum was told
                                                                           that she would eventually
                                                                           have to undergo surgery
                                                                           to rebuild the weakened
                                                                           valve. Rather than wait,
                                                                           she immediately sought
                                                                           out a surgeon who could
                                                                           do a minimally invasive
                                                                           repair, allowing for minor
                                                                          incisions and a speedy
                                                                         recovery. After an extensive
                                                                     search, Ms. Baum selected Dr.
       Aubrey Galloway at NYU, based on his extensive track record and “easy-going” bedside
       manner. “He was the obvious choice,” she says. The surgery, which took place in April 2006,
       was uneventful. Two weeks later, she was back in the gym, doing light workouts. “You think
       about heart surgery—it’s so overwhelming. But by June, I was running around on the beach
       with my kids,” says Ms. Baum. “We’d love to have another child. Now, I can.”




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                                          In thoracic surgery, we have a number of research projects,
                                        including a study of early detection of lung cancer and mesothelioma
                                        (malignant growths of the covering of the lung or the lining of the
                                        pleural and abdominal cavities, commonly associated with asbestos
                                        exposure). At the Bellevue Thoracic Surgical Laboratory, we are
                                        investigating biomarkers for early detection of benign and malignant
                                        diseases of the chest, among other topics. Additional investigators in
                                        our group are developing the use of autofluorescence bronchoscopy
                                        for early detection of precancerous cells from the sputum of patients
                                        at high risk for lung cancer. Another team is investigating nonsurgical
                                        techniques of destroying lung cancers (including radiofrequency
                                        ablation and stereotactic radiation) in order to provide treatment
                                        options for patients who cannot safely undergo surgery. Finally, we
                                        are participating in the International Early Lung Cancer Action Project,
                                        whose goal is to improve the diagnosis and treatment of lung cancer
                                        and ultimately bring about a cure.
                                          In recent years, our staff has been influential in securing FDA
                                        approval of two novel thoracic cancer therapies, including a light-
                                        activated, or photodynamic, therapy for endobronchial lung cancer
                                        and an autofluorescence bronchoscopy system for the detection of
                                        precancerous cells in the lung.




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                                        NYU Medical Center:
                                        World-Class Tertiary Care
                                        The strengths of NYU Cardiothoracic Surgery extend beyond our
                                        offices and operating rooms. Our practice is an integral component of
                                        NYU Medical Center, one of the nation’s foremost centers of
                                        excellence in health care, biomedical research, and medical education.
                                        The Medical Center consists of NYU School of Medicine and the three
                                        hospitals of NYU Hospitals Center, including Tisch Hospital, a 726-bed
                                        acute-care general hospital; Rusk Institute of Rehabilitation Medicine,
                                        the first and largest facility of its kind; and NYU Hospital for Joint
                                        Diseases, a leader in musculoskeletal care. NYU is consistently ranked
                                        among the leading health-care institutions in the country.
                                          Our patients benefit from NYU’s vast expertise every day. Our
                                        cardiac surgeons regularly consult and collaborate with specialists in
                                        NYU’s Cardiac & Vascular Institute, including faculty from the Leon H.
                                        Charney Division of Cardiology, the Interventional Radiology and
                                        Endovascular Surgery Service, the Cardiac Rehabilitation and
                                        Prevention Center (a component of the Rusk Institute of Rehabili-
                                        tation Medicine), the Electrophysiology and Arrhythmia Service, the
                                        Leon H. Charney Heart Rhythm Center, the Echocardiography




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                                        Laboratory, the Pediatric Cardiology Service, the Cardiac Intensive
                                        Care Service, and the Cardiac Anesthesia Service.
                                           On the thoracic side, our surgeons regularly consult and
                                        collaborate with specialists in NYU’s renowned Clinical Cancer
                                        Center and Cancer Institute, the Division of Medical Oncology, the
                                        Division of Pulmonary and Critical Care Medicine, the Pulmonary
                                        Function Laboratory, and the Thoracic Anesthesia Service.
                                           With ready access to the resources of NYU Medical Center, we are
                                        able to offer patients many treatment options not available at other
                                        institutions as well as the opportunity to participate in exclusive
                                        clinical trials.

                                        Education & Outreach
                                        As a part of an academic medical center, our staff is actively involved
                                        in teaching and training, including residency and fellowship
                                        programs in cardiothoracic surgery and thoracic surgery. We also
                                        participate in distance learning and teleconferencing, using
                                        innovative tools such as high-definition video for visualizing the heart
                                        and chest during minimally invasive surgery, a technique pioneered
                                        here at NYU. Additionally, our surgeons are regularly invited to
                                        lecture on advances in cardiothoracic surgery around the world.
                                           The staff of NYU Cardiothoracic Surgery also make a point of
                                        reaching out to communities down the street and around the globe.




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                                         Situated in a multicultural community in the world’s most diverse city,
                                         we are closely attuned to health-care needs of different cultures. We
                                         are building strong ties to the Latino community both here and
                                         abroad, through a variety of outreach efforts, including translation of
                                         medical information, surgical consultations with Latino practitioners,
                                         and exchange programs for Latino medical students and residents
                                         from universities in South America and Spain.
                                           For years, we have been sponsoring the care of sick children from
                                         medically underserved regions the world over, bringing them to NYU
                                         for heart surgery and other advanced treatment. Expanding upon this
                                         work, several members of our practice formed a nonprofit venture
                                         called Project Kids Worldwide, whose mission is to make life-saving
                                         surgery available to, and improve medical treatment for, impoverished
                                         children with congenital and acquired heart disease around the globe.
                                           Moreover, our thoracic surgeons are actively involved in advocacy
                                         for patients with lung cancer and mesothelioma, serving on the
                                         medical advisory board of the Lung Cancer Alliance and on the
                                         scientific advisory board of the Mesothelioma Applied Research
                                         Foundation.




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       Three’s a Charm
       Having one child undergo
       surgery is stressful enough,
       but imagine having three in
       the O.R. on the same day!
       That was what John and
       Evelyn Hess of Mount
       Vernon, N.Y., faced on
       May 2, 2006. Each of their
       triplets, who were delivered
       three months early at NYU,
       needed surgery to repair a
       patent ductus arteriosus
       (PDA), a hole between the
       aorta and the pulmonary
       artery that normally closes
       after birth, but not in many
       preemies. The smallest of
       the three weighed in at
       1 lb. 2 oz., the largest at
       1 lb. 12 oz. “They were so
       premature, the doctors in
       the neonatal care unit didn’t
       know if they were going to
       survive, even before the
       surgery,” says Ms. Hess. “We
       were terrified.” One by one,
       the tiny babies were taken
       into the O.R. by Dr. David
       Meyer for a PDA ligation, a
       minimally invasive procedure to close
       the stubborn hole. “It was probably the toughest day of my life,” says their mom. “But
       Dr. Meyer was fantastic. We had total confidence in him.” Today, a year later, the babies—
       Audriana, Darius, and Domenica—are struggling a bit with problems common to preemies, but
       their hearts are strong. “They are doing well,” Ms. Hess beams. “They are catching up.”




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                                         What is Minimally
                                         Invasive Surgery?

                                         In traditional open-heart surgery, the heart
                                         is reached by cutting open the chest and
                                         dividing the breast bone—the most traumatic
                                         aspect of the operation—giving the surgeon
                                         room to connect the heart to the heart-lung
                                         machine and to repair the heart.
                                            In minimally invasive surgery, the surgeons
                                         accesses the heart via small incisions in the
                                         patient’s chest and groin. Tubes for the heart-
                                         lung machine (a pair of catheters) are
                                         threaded to the heart through the incisions,
                                         while the repair itself is performed through a
                                         smaller-than-usual incision between two ribs.
                                         As a result, patients experience less postop-
                                         erative pain, need fewer blood transfusions,
                                         and have dramatically quicker recoveries.
                                            Another recent innovation is “off-pump,”
                                         or “beating heart,” surgery. In this technique,
                                         certain areas of the heart are immobilized
                                         with cardiac stabilizers, allowing the surgeon
                                         to operate while the heart is still beating. This
                                         avoids the need to place the patient on a
                                         heart-lung machine, a major benefit for
                                         certain high-risk cases, including the elderly.
                                            Minimally invasive techniques have also
                                         revolutionized thoracic surgery. A major
                                         advance is video-assisted thoracoscopy, in
                                         which the surgeon operates through two to
                                         four small openings between the ribs, while
                                         viewing the patient’s internal organs on a
                                         video monitor. Each opening is less than one
                                         inch in diameter, compared to six-to-ten-inch
                                         incisions in traditional open surgical
                                         approaches.




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                                         OUR CLINICAL SERVICES


                                         Cardiac Surgery
                                         We treat all manner of heart disease in adults and children, with
                                         dedicated programs in Valvular Disease, Coronary Artery Disease,
                                         Congenital Heart Disease, Arrhythmias, Thoracic Aneurysms, and
                                         Heart Failure.

                                         Valvular Disease Program. NYU is a world leader in the treatment
                                         of heart valve disease, having performed more than 3,500 mitral
                                         valve repairs. In valve disease, one or more of the valves fail to open
                                         or close properly, causing blood to flow backward in the heart. The
                                         most common valve problems are mitral valve prolapse with mitral
                                         regurgitation, mitral stenosis, aortic stenosis, and aortic regurgitation.
                                         Virtually all our patients with valve disease are treated with minimally
                                         invasive surgery. For those with mitral valve disorders, we offer valve
                                         repair or replacement (using natural tissue or artificial valves). Valve
                                         repair offers considerable advantages over replacement, as it
                                         eliminates the need for long-term anticoagulant therapy and lasts




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                                         longer. For patients with aortic valve disorders, we now offer
                                         improved natural tissue valves, which result in fewer complications
                                         than with traditional mechanical valves.

                                         Coronary Artery Disease Program. The full range of therapies for
                                         coronary artery disease, a condition in which the blood supply to the
                                         heart muscle is partially or completely blocked, are available at NYU.
                                         Our treatments include a variety of revascularization procedures,
                                         including coronary balloon angioplasty and stenting, as well as
                                         leading edge coronary artery bypass graft (CABG) surgery. Most
                                         surgeons use primarily vein grafts when performing CABG surgery. At
                                         NYU, however, almost all our CABG operations are done using
                                         arterial grafts, which have been shown to remain open longer and to
                                         improve survival rates, compared to vein grafts. Roughly half our
                                         CABG surgeries are performed “off pump,” eliminating the need to
                                         place patients on a heart-lung machine, considerably lowering
                                              surgical risks, particularly among the elderly. Our faculty have
                                              one of the largest experiences with CABG surgery in the
                                              country, with more than 20,000 coronary bypass operations
                                              performed at NYU over the last three decades.

                                              Heart Failure Program. We take an aggressive, multidisci-
                                              plinary approach to the treatment of patients with heart failure,
                                              a life-threatening condition in which the heart muscle grows
                                              progressively weaker and cannot pump enough blood to meet
                                              the body’s needs for oxygen and nutrients. Every patient is
                                              managed by a team of surgeons and heart failure cardiologists,
                                              who in turn are backed by a team of specialists in cardiac
                                              imaging, cardiology, interventional cardiology and cardiac
                                              rehabilitation. Using this team approach, we are able to offer
                                         patients the widest range of treatment options—including medical
                                         therapy, catheterization procedures, electrophysiology procedures,
                                         and reconstructive surgery—greatly improving their prospects for
                                         survival as well as their quality of life. Among our advanced surgical
                                         therapies for heart failure are mitral valve repair, atrial fibrillation
                                         surgery, ventricular restoration surgery, and ventricular assist devices,
                                         with referral for heart transplantation.

                                         Congenital Heart Disease Program. Our surgeons have extensive
                                         experience in treating congenital heart disease—defects in one or
                                         more structures of the heart or blood vessels that occur before birth.




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                                         These include ventricular and atrial septal defects, atrioventricular
                                         canal, tetralogy of Fallot, patent ductus arteriosus, transposition of
                                         the great arteries, truncus arteriosus, hypoplastic left heart syndrome,
                                         and valve disease. We bring an integrated approach to care, working
                                         with our colleagues in pediatrics, pediatric cardiology, and pediatric
                                         critical care. Whenever possible, we use minimally invasive surgical
                                         approaches, and we make every effort to provide a comfortable
                                         environment for patients and families. Unlike most congenital heart
                                         disease programs, we also specialize in the treatment of adults with
                                         congenital heart disease—those who survive into adulthood with
                                         congenital heart defects. The most common congenital heart
                                         disorders that affect adults are congenital valve defects, atrial and
                                         ventricular septal defects, and patent foramen ovale.

                                         Thoracic Aneurysm Program. We specialize in the treatment of
                                         aneurysms that occur in the thoracic aorta (the portion of the body’s
                                         main artery that runs through the chest). Aneurysms—weak bulging
                                         areas in the wall of a blood vessel—are a serious health risk. Without
                                         warning, they can rupture, causing severe internal bleeding, which in
                                         turn can lead to shock or death. Aneurysms are typically treated using
                                         conventional “open” surgical approaches in which the weakened
                                         portion of the aorta is replaced with a fabric tube, called a graft.
                                         More and more aneurysms, depending on their location and
                                         complexity, can be repaired with a minimally invasive procedure




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                                         known as an endovascular stent-graft. In this procedure, instead of
                                         opening the chest, a catheter is inserted into a groin artery and
                                         guided up into the aorta, where a special stent is placed at the site of
                                         the aneurysm. We also perform surgical repairs of aortic dissections
                                         (separations of the layers of the aorta).

                                         Arrhythmia Surgery/Electrophysiology Program. NYU offers the
                                         most advanced treatments of arrhythmias (heart rhythm disorders)
                                         available anywhere in the world. Each patient is treated using a team
                                         approach, developed by the Cardiac Rhythm Center, including
                                         specialists in electrophysiology, cardiac surgery, and heart failure.
                                         Among the conditions we treat are atrial fibrillation, atrial flutter,
                                         bradycardia, tachycardia, and Wolff-Parkinson-White syndrome. Most
                                         of our patients with atrial fibrillation are treated by eradicating the
                                         source of the arrhythmia, either with radiofrequency energy (similar
                                         to microwave heat), performed by our electrophysiologists in the
                                         catheterization laboratory, or with minimally invasive surgical
                                         approaches. In certain patients with atrial fibrillation, namely those
                                         already requiring surgery for other cardiac disease, such as valvular
                                         stenosis or insufficiency, a minimally invasive Maze ablation procedure
                                         is routinely used. In this procedure, the surgeons makes a precise
                                         pattern of incisions around the source of the arrhythmia, which are
                                         then sutured back together, ultimately forming scar tissue that
                                         prevents the abnormal electrical patterns from passing through heart.

                                         Thoracic Surgery and Thoracic Oncology
                                         Our rapidly growing Division of Thoracic Surgery and Thoracic
                                         Oncology specializes in the diagnosis and treatment of the full range
                                         of benign and malignant disorders of the thoracic cavity, the portion
                                         of the body comprising the lungs, esophagus, trachea, mediastinum,
                                         and chest wall.
                                           Thoracic disorders are typically complex, necessitating a multidisci-
                                         plinary approach to treatment. At NYU, each case is reviewed by a
                                         tightly integrated team of specialists, involving experts in thoracic
                                         surgery, medical oncology, radiation oncology, pulmonary medicine,
                                         and radiology, as necessary.
                                           We employ the full range of treatment strategies, including such
                                         mainstays as chemotherapy, radiation therapy, and surgery, as well as
                                         a number of advanced therapies found at only a handful of academic
                                         medical centers. Whenever possible, we employ minimally invasive




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                                                                            Alive and Well
                                                                            It’s every patient’s worst
                                                                            nightmare: You go for a
                                                                            regular checkup, feeling
                                                                            perfectly fine, and the
                                                                            doctor spots a mass on
                                                                            your chest X-ray—it’s lung
                                                                            cancer. This bad dream
                                                                            came true for Joyce
                                                                            Cantone of Brooklyn in
                                                                            October 2005. “I was numb
                                                                            and frightened,” she
                                                                            recalls. “You always hear
                                                                            that lung cancer is fatal.
                                                                            Goodbye!” However, her
                                                                            doctors at NYU—Drs.
                                                                            Abraham Chachoua and
                                                                            Harvey Pass—found that
                                                                            the cancer had not spread
                                                                            and, even though it was
                                                                            advanced, it was treatable.
                                                                            After undergoing three
                                                                            surgeries at NYU—two
                                                                            minimally invasive
                                                                            procedures to remove
                                                                            affected lymph nodes in
                                                                            the chest, followed by a
                                                                            lobectomy, an “open”
                                                                            operation to remove the
                                                                            tumor itself and a part of
                                                                            the lung—Ms. Cantone is
                                                                          alive and well. A life-long
                                                                       smoker, she quit the habit
       immediately after her diagnosis. Otherwise, her life is back to normal. Nowadays, she comes to
       NYU every three months for an X-ray and a checkup, which takes no more than a few hours
       from her busy schedule. “They are very good about that, so I can get right back to work,” she
       says. “Everyone at the hospital, from day one, has been very nice, very calming.”




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                                         approaches to diagnosis and therapy, including video-assisted
                                         thoracoscopy and laparoscopy, which greatly reduce postoperative
                                         pain and shorten recovery times, and we are constantly incorporating
                                         innovative technologies into our practice.

                                         Lung Cancer. NYU is highly regarded for its expertise in treating lung
                                         cancer and pulmonary metastases (secondary cancers formed by
                                         transmission of cancerous cells from a primary tumor located
                                         elsewhere in the body). We offer the latest diagnostic and treatment
                                         approaches, including endobronchial ultrasound, a new technique for
                                         lymph node biopsy that does not require an overnight hospital stay;
                                         autofluorescence bronchoscopy, in which conventional white light
                                         and fluorescent light sources are used to detect precancerous cells;
                                         photodynamic therapy, a laser-activated drug treatment for various
                                         cancers; and radiofrequency ablation, which employs radiowaves to
                                         destroy lung tumors. As appropriate, we offer qualified candidates
                                         access to the latest clinical trials for lung cancer, such as tests of
                                         stereotactic body-radiation therapy and targeted molecular therapies.

                                         Mesotheliomas. NYU is also well known as a referral center for
                                         patients with mesotheliomas. Commonly associated with asbestos
                                         exposure, mesotheliomas are malignancies in tissues that cover the



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                                         lung or line the pleural and abdominal cavities. Our expertise covers
                                         all aspects of the disease, from diagnosis to medical therapy and
                                         surgical management. We offer two advanced surgical options,
                                         including pleurectomy/decortication (removal of the pleura without
                                         removing the entire lung) and extrapleural pneumonectomy (removal
                                         of the pleura, diaphragm, pericardium, and the whole lung involved
                                         with the tumor).

                                         Esophageal Disease. Our team also specializes in cancer of the
                                         esophagus (the muscular tube for passage of food from the pharynx
                                         to the stomach). Many of our patients are treated with a minimally
                                         invasive approach, using laparoscopy and thoracoscopy. We have
                                         expertise in using stents to relieve blockages in the esophagus due to
                                         cancer, restoring one’s ability to swallow. In addition, we have
                                         extensive experience treating achalasia (a benign disease of the
                                         esophagus that leads to difficulty swallowing), gastroesophageal
                                         reflux disease, and esophageal and hiatal hernias. In most cases,
                                         treatment of achalasia and hiatal hernias can be performed with
                                         minimally invasive approaches, allowing patients to return home in a
                                         matter of days.

                                         Tracheal Disease. Our surgeons have expertise in managing difficult
                                         airway problems, using laser techniques and stenting of the trachea,
                                         among other therapies.




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                                         THE ROAD TO RECOVERY

                                         After Surgery
                                         After surgery, patients are sent directly to one of our intensive care
                                         units, which are staffed 24 hours a day, seven days a week by critical
                                         care specialists who are part of our multidisciplinary team. These
                                         physicians work closely with our cardiothoracic surgeons, cardiol-
                                         ogists, pulmonary specialists, and nurse practitioners to ensure that
                                         our patients are as comfortable as possible. They also deliver regular
                                         daily updates to patients and their families and oversee transfers to
                                         general patient floors—readying patients for the next phase of care:
                                         rehabilitation.

                                         Cardiac and Pulmonary Rehabilitation
                                         Rehabilitation is essential to recovering from cardiopulmonary disease.
                                         We encourage our patients, when appropriate, to obtain care at the
                                         Joan and Joel Smilow Cardiac and Pulmonary Rehabilitation and
                                         Prevention Center at NYU or at another rehabilitation program.
                                           The Smilow Cardiac and Pulmonary Rehabilitation and Prevention
                                         Center, a component of the renowned Rusk Institute of Rehabilitation
                                         Medicine, offers the most comprehensive cardiopulmonary wellness
                                         and rehabilitation services in the tri-state area. Both inpatient and
                                         outpatient services are provided, helping patients move seamlessly
                                         into the recovery phase of their care. Facilities include a 22-bed
                                         inpatient unit, a state-of-the-art cardiopulmonary rehabilitation gym,
                                         and dedicated space for patient education.
                                           NYU’s rehabilitation program takes a multidisciplinary, individu-
                                         alized approach to patient care, aimed at enhancing activity and
                                         functional independence, reducing symptoms, improving overall
                                         health, modifying health risk factors, promoting awareness of healthy
                                         lifestyles, and encouraging appreciation of mind-body interactions in
                                         health and illness.
                                           In support of these goals, the Center offers a host of a la carte
                                         services, including acupuncture, anger and stress management,
                                         diabetes management, fitness consultations, individualized
                                         psychotherapy, massage therapy, nutrition, occupational and cognitive
                                         therapy, smoking cessation, Tai Chi, weight management, and
                                         women’s heart-health education and assessment programs.




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       NYU CARDIOTHORACIC SURGERY: PHYSICIAN PROFILES
       Aubrey C. Galloway, MD                                                Harvey I. Pass, MD
       Chairman, Department of Cardiothoracic Surgery                        Professor of Cardiothoracic Surgery
       Seymour Cohn Professor of Cardiothoracic Surgery                      Chief, Division of Thoracic Surgery
       Director, Thoracic Surgery Residency Program                          Chief, Thoracic Oncology, NYU Cancer Center
       NYU School of Medicine                                                Associate Director, Thoracic Surgery Residency Program
                                                                             NYU School of Medicine
                            SPECIALTY INTERESTS: Minimally invasive
                            cardiac surgery, mitral valve repair, valvular                        SPECIALTY INTERESTS: All aspects of thoracic
                            heart disease, coronary artery bypass                                 oncology, including surgical management of
                            surgery with arterial grafts, off-pump                                lung cancer, mesothelioma, pulmonary
                            coronary bypass surgery, adult congenital                             metastases, esophageal cancer, and
                            heart surgery, surgery for thoracic                                   neoadjuvant therapy for Stage III lung cancer;
                            aneurysms and aortic dissections, and                                 minimally invasive surgical procedures,
                            reconstructive surgery for congestive heart                           including lobectomy, and lung sparing options
                            failure and ventricular aneurysms.                                    including segmentectomy; extrapleural
                                                                                                  pneumonectomy and treatment options for
                                                                                                  mesothelioma.



      CARDIAC SURGERY

      Stephen B. Colvin, MD                                                  Eugene C. Grossi, MD
      Professor of Cardiothoracic Surgery                                    Professor of Cardiothoracic Surgery
      Founding Chairman, Department of Cardiothoracic Surgery                Director, Cardiac Surgical Research
      NYU School of Medicine                                                 NYU School of Medicine
                           SPECIALTY INTERESTS: Minimally invasive           Chief, Cardiothoracic Surgery
                           cardiac surgery, mitral valve repair, valvular    Veterans Administration Hospital (Manhattan)
                           heart disease, surgery for congenital heart                             SPECIALTY INTERESTS: Minimally invasive
                           disease in children and adults, off-pump                                surgical treatment of arrhythmias, adult and
                           coronary bypass surgery, surgery for                                    pediatric pacemakers and defibrillators, valve
                           congestive heart failure and ventricular                                repair and replacement, traditional and off-
                           aneurysm repair.                                                        pump coronary bypass surgery, and surgical
                                                                                                   treatment of heart failure.


       Alfred T. Culliford, MD
       Professor of Cardiothoracic Surgery
       NYU School of Medicine                                                Greg H. Ribakove, MD
                                                                             Associate Professor of Cardiothoracic Surgery
                            SPECIALTY INTERESTS: Coronary artery
                                                                             Associate Director, Thoracic Surgery Residency Program
                            bypass grafting with arterial grafts,
                                                                             Director, Surgical Heart Failure Program
                            surgical repair of thoracic aortic
                                                                             NYU School of Medicine
                            aneurysms and dissections, and surgical
                                                                             Chief, Cardiothoracic Surgery, Bellevue Hospital Center
                            treatment and management of elderly
                            patients with valvular and coronary artery                             SPECIALTY INTERESTS: Minimally invasive valve
                            disease.                                                               surgery, traditional and off pump coronary
                                                                                                   bypass surgery, reconstructive surgery for heart
                                                                                                   failure, left ventricular assist device surgery for
                                                                                                   heart failure, and surgery for cardiogenic
                                                                                                   shock.




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       Gregory A. Crooke, MD                                                   THORACIC SURGERY
       Assistant Professor of Cardiothoracic Surgery
       Director, Left Ventricular Assist Device Program                        Costas Bizekis, MD
       NYU School of Medicine                                                  Assistant Professor of Cardiothoracic Surgery
                             SPECIALTY INTERESTS: Reconstructive               Director, Esophageal Surgery Program
                             surgery for heart failure, high risk coronary     NYU School of Medicine
                             bypass surgery, left ventricular assist device    Director, General Thoracic Surgery, Bellevue Hospital
                             surgery for heart failure, valve repair and                             SPECIALTY INTERESTS: Minimally invasive
                             replacement, and adult congenital cardiac                               thoracic surgery, esophageal cancer, benign
                             surgery.                                                                esophageal disorders, endoscopic palliation
                                                                                                     of esophageal cancer, stents, photodynamic
                                                                                                     therapy, radiofrequency ablation of Barrett’s
                                                                                                     esophagus, lung cancer, radiofrequency
                                                                                                     ablation of lung cancer
       Juan B. Grau, MD
       Assistant Professor of Cardiothoracic Surgery
       Director, Minority Outreach Program for Prevention
         of Healthcare Disparities                                             Bernard K. Crawford, Jr., MD
       Director, Undergraduate Medical Education                               Assistant Professor of Cardiothoracic Surgery
       Associate Director, Cardiac Surgical Research                           Director, General Thoracic Surgery, Tisch Hospital
       NYU School of Medicine                                                  NYU School of Medicine
                             SPECIALTY INTERESTS: Coronary artery                                    SPECIALTY INTERESTS: General thoracic
                             bypass surgery with arterial grafts, off-pump                           surgery, video-assisted minimally invasive
                             bypass surgery, valve repair and                                        and traditional surgical treatment of lung
                             replacement, and surgery for thoracic                                   cancer, tumors of the mediastinum, thymus,
                             aneurysms and aortic dissections.                                       esophagus, diaphragm, and chest wall.




       David B. Meyer, MD                                                      Jessica S. Donington, MD
       Assistant Professor of Cardiothoracic Surgery                           Assistant Professor of Cardiothoracic Surgery
       Director, Pediatric and Congenital Cardiac Surgery Program              Director, Thoracic Surgery Translational Laboratory
       NYU School of Medicine                                                  NYU School of Medicine
                             SPECIALTY INTERESTS: Neonatal, pediatric                                SPECIALTY INTERESTS: Benchwork studies of
                             and adult congenital cardiac surgery, surgery                           thoracic neoplasm diagnosis and treatment;
                             for aortic root reconstruction, homografts                              development of clinical protocols for novel
                             and autografts, pediatric cardiac                                       methods for the diagnosis and treatment of
                             pacemakers, and benign congenital diseases                              thoracic malignancies; general thoracic
                             of esophagus, trachea and chest in neonates                             surgery including thoracic oncology, minimally
                             and children.                                                           invasive thoracic surgery, video thoracoscopic
                                                                                                     thoracic surgery, esophageal surgery,
                                                                                                     mediastinal tumors, chest wall surgery.

       Charles F. Schwartz, MD
       Assistant Professor of Cardiothoracic Surgery                           Michael D. Zervos, MD
       Director, Thoracic Aortic Stent Graft Program                           Assistant Professor of Cardiothoracic Surgery
       NYU School of Medicine                                                  NYU School of Medicine
                            SPECIALTY INTERESTS: Surgery for thoracic          Director, General Thoracic Surgery, Manhattan Veterans Hospital
                            aortic aneurysms and aortic dissections,                                 SPECIALTY INTERESTS: General thoracic
                            specialization in stent-graft repair of thoracic                         surgery, including thoracic oncology,
                            aortic aneurysms, coronary artery bypass                                 minimally invasive thoracic surgery, video-
                            surgery with arterial grafts, off-pump bypass                            assisted thoracoscopy, esophageal surgery,
                            surgery, minimally invasive cardiac surgery,                             chest-wall surgery, and thoracic spine
                            and valve repair and replacement.                                        exposure with open and thoracoscopic
                                                                                                     approaches.


                                                                                                                                                 23
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       OUR SPECIALTIES


       Cardiac Surgery                                   Thoracic Surgery
       CONDITIONS                                        CONDITIONS
       ❖ Aortic dissections                              ❖ Achalasia
       ❖ Aortic insufficiency (leaking aortic valve)     ❖ Aortic aneurysms
       ❖ Aortic stenosis (blocked aortic valve)          ❖ Airway diseases: benign & malignant
       ❖ Arrhythmias                                     ❖ Chest wall defects
       ❖ Cardiac tumors                                  ❖ Endobronchial and tracheal obstructions
       ❖ Congenital heart defects (adult and children)   ❖ Esophageal disease
       ❖ Coronary artery disease                         ❖ Gastroesophageal reflux disease
       ❖ Heart failure                                   ❖ Hiatal/esophageal hernias
       ❖ Mitral segurgitation (leaking mitral valve)     ❖ Hyperhidrosis (excessive sweating)
       ❖ Mitral stenosis (blocked mitral valve)          ❖ Infectious lung disease
       ❖ Thoracic aortic aneurysms                       ❖ Pulmonary emboli
                                                         ❖ Pulmonary metastases
       TECHNIQUES                                        ❖ Mesothelioma
       ❖ Aortic dissection repair                        ❖ Myasthenia gravis
       ❖ Aortic valve replacement                        ❖ Severe emphysema
       ❖ Automatic implantable cardiac defibrillators    ❖ Swallowing disorders
       ❖ Beating heart, or off-pump, coronary artery     ❖ Thoracic aneurysms
           bypass surgery                                ❖ Thoracic trauma
       ❖ Congenital heart defect repairs                 ❖ Tumors of the chest wall, diaphragm,
       ❖ High-risk adult surgery                           esophagus, lung, or thymus
       ❖ Minimally invasive surgery
       ❖ Multi-vessel coronary artery bypass grafting    TECHNIQUES
       ❖ Mitral valve repair, reconstruction, or redo    ❖ Endobronchial stents
       ❖ Pediatric surgery                               ❖ Endobronchial ultrasound
       ❖ Radiofrequency tissue ablation                  ❖ Fluorescence bronchoscopy
       ❖ Total arterial coronary revascularization       ❖ Lung transplantation
       ❖ Tricuspid valve repair                          ❖ Lung volume reduction surgery
       ❖ Ventricular restoration (Dor procedure)         ❖ Minimally invasive biopsies
                                                         ❖ Minimally invasive surgery
                                                         ❖ Nd:Yag laser surgery
                                                         ❖ Pediatric surgery
                                                         ❖ Photodynamic therapy
                                                         ❖ Radiofrequency tissue ablation
                                                         ❖ Video-assisted thorascopy, laparoscopy, and
                                                           mediastinoscopy
109911W1   5/21/07   8:53 PM   Page 25




                                         CREDITS

                                         Writer: Gary Goldenberg
                                         Designer: Tanya Krawciw
                                         Photographers: Paul J. Bereswill (pp. 2, 4,
                                         5, 7 top, 12 bottom, 14-17, 19, back cover);
                                         Carlos Rene Perez (cover insets, pp. 1, 3,
                                         6, 7 bottom, 8, 9, 12 top, 13, 18, 20, 21);
                                         Jesse Ward (12-13)
109911W1   5/21/07     8:52 PM      Page c4




             NYU CARDIOTHORACIC SURGERY
             NYU Medical Center
             530 First Avenue, Suite 9V
             New York, NY 10016


             For more information:

             PATIENTS:
             212-263-2190

             PHYSICIANS:
             Ellen R. Cherrick, Administrator
             212-263-3277
             ellen.cherrick@med.nyu.edu

             Visit us on the Web at:
             www.med.nyu.edu/cvsurgery/




                     SCHOOL OF
                     MEDICINE




              NEW YORK UNIVERSITY