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NY Cardiothoracic Group, PLLC
Westchester Medical Center
Valhalla, NY 10595
914 493-8793

Summary of Clinical Topics

Drs. Lansman and Spielvogel founded The New York Cardiothoracic Group (NYCTG) in 2005, when Dr. Lansman was recruited to become Chief of Cardiothoracic Surgery at Westchester Medical Center. NYCTG is comprised of 4 cardiothoracic surgeons, Drs. Lansman, Malekan, Saunders and Spielvogel, who are committed to providing the best results, with the most reliable of current therapies in this specialty. It has been a busy, productive 5 years and the following is a summary of clinical outcomes and exciting areas that are being developed.

Coronary bypass grafting (CABG) remains a large part of our practice. The age range, acuity, spectrum of severity and co-morbidities in this group truly constitute “high risk,” tertiary referral patients, yet the outcomes have been excellent. In fact, the NYCTG results have consistently compared very favorably with those reported by the New York State Department of Health Cardiac Surgery Advisory Committee (below) and our faculty includes one of the few surgeons whose results were statistically higher than the statewide rate in the most recent report.

Valve and CABG/Valve and Multiple Valve procedures, often including arrhythmia procedures and aneurysm surgery, made up most of the remaining cases. Here too, the NYCTG results have compared very favorably for with available statewide data (below).

In addition, there are a number of subspecialty areas, Mitral Valve Repair, Aortic Aneurysm Surgery and Heart Transplant/Mechanical Assist Device Procedures that the group has expertise in.

Mitral Valve Repair: The last 100 mitral valve repair procedures were recently reviewed. A repair was successfully performed in 98% of cases in which a repair was intended, with 1 mortality for the entire group. Many cases required a complex repair, including leaflet resections, leaflet extensions and construction of Gortex “neo-chordae.” In appropriate cases, we use a minimal access technique.

Aortic Aneurysm Surgery: We have performed over 250 cases, spanning the spectrum of aortic procedures, including valve-sparing root replacements; full arch replacements, using hypothermic circulatory arrest; thoracoabdominal replacements, using somatosensory and motor evoked potential monitoring; and many re-operative procedures. We are rapidly becoming a referral center for acute aortic dissections for the entire region and have performed 86 repairs for acute dissection, with 1.2% mortality. The overall mortality, for all aneurysm procedures, is 2.4%. When appropriate, we are employing a less invasive, endovascular stent approach.

Dr. Spielvogel has lectured at national and international meetings on his method of aortic arch replacement, the trifurcated graft technique (below), which is becoming adopted internationally. For preoperative and postoperative aneurysm patients, we inaugurated an Aortic Aneurysm Follow-up Program that includes a nurse practitioner and a custom-developed database to implement surveillance protocols for these patients. For a more comprehensive overview of the NYCTG Aortic Aneurysm Program, please see www.AorticSurgery.org.

Cardiac Transplant – Mechanical Circulatory Support (MCS) Device Program: We have performed 33 heart transplants, including 12 mechanical assist “bridges-to-transplant,” 2 heart-kidney transplants and 1 heart-liver transplant (the 62nd such case in the world); all 33 patients were successfully discharged from the hospital. We have also implanted over 60 assist devices, including the Impella, Tandem Heart, ABIOMED Ventricle, JARVIK 2000 rotary device and the HeartMate I and HeartMate II devices. Recently the Joint Commission awarded Disease Specific Certification status to our MCS program. While WMC has implanted many assist devices for patients awaiting cardiac transplant, the significance of Joint Commission certification is that we can now implant devices for long-term support, also known as “destination therapy.” Through this designation, WMC can offer many more heart failure patients an alternative for end-stage cardiac disease.