Barry J. Feldman, MD, gives an overview of the Heart & Vascular service line, discusses its structure, and explains how our general cardiologists and subspecialists deliver exceptional care to your patients.
From Interventional Cardiology and Advanced Heart Failure to Structural Heart and Electrophysiology, we’re doing even more to return your patients to you in the best health.
To learn more about our advanced offerings, please watch the video.
I'm Doctor Barry Feldman. It's a pleasure for me to share with you a little bit about our service line program. We're very excited about what we can offer you. This is a comprehensive program that covers approximately two thirds of the state, which primarily is in the upstate in the Midlands. But as the complexity of cardiologists evolved, we now feel that we really need to have sub specialists in the service line. And so now we have chosen physicians who are the best at what they do in each subspecialty to care for you. That does not mean that you don't need a general cardiologist to help oversee the entire um care plan. So we also have general cardiologists that worked both with sub specialists. So what makes us unique is that we are really focused on our mission is to care for the citizens of south Carolina. We're not outside corporation or a large corporation that seeks to come into a state but really provide care for our citizens are interventional cardiology program has evolved first by acquiring some of the most quality and talented interventionists in the state. We have gone out of the way to recruit people with special skill sets so that they can provide difficult care and difficult patients such as patients who have chronic total inclusions, patients who have complex blockages which are difficult to get to that. The average interventional cardiologists can't get to. In addition to doing the everyday bread and butter stents we use the newest stents available. The drug eluting stents. We also use extents that have uh anti coagulant properties as well. In addition to putting stents in, we look at assessment of the blockages physiologically we can now do what we call pressure wires. We can place wires across the blockage and measure whether the blockages physiologically significant. We can also do O. C. T. Or optical coherence tomography. To look at these lesions all the way through the wall of the blood vessels, determine what is the composition of the blockage. And we can also do intravascular ultrasound so that we can actually see what amount of plaque there is and what type of calcium there is. That also helps us with the characteristics of the lesion that helps us decide how to treat these lesions. So using some of these newer diagnostic imaging technologies in the Cath lab has been a very effective way to provide the patient the very best care in interventional cardiology. I would like to share with you a little bit about our advanced heart failure program. We're very proud of this program in Prison health since we are one of the first accountable care units in the country for heart failure that we've evolved in the Midlands at the Heart hospital. We've taken this model and also transfer that to Greenville. The advanced heart failure accountable care units allow us to geographically collate patients who have heart failure in one part of the hospital and allows for sub specialists in heart failure in conjunction with nurse practitioners, pharmacists, social workers and families to have structural bedside rounding uh for them to be able to provide a comprehensive effective treatment plan for the patients in the heart hospital. Once this is established, they also have a link to the outpatient area which is the advanced heart for the clinic and the advanced heart into the clinic. Many of the same people who see them on the inpatient side, see them on the outpatient side. So they give continuity of care. And in the outpatient clinic again we have pharmacists who are embedded into the system to help patients obtain sometimes expensive drugs which are difficult to get. They can also provide outpatient iron infusions through through the vein to prevent hospitalization. They give out patient intravenous Lasix prevent them to go into the emergency room and they can provide most importantly access to care access to care. Uh in a very timely fashion is very important. Now we've also adopted some of the ep devices which have the ability to measure and use artificial intelligence type algorithms when the patient will be developing heart failure well before they have any symptoms. So we can assess patients remotely through these devices and help them adjust their medications before they have symptoms. Another very useful adjunct to this is using what we call it cardio memes and also in the upstate we use a device called a chord ella. So use the cordelia and the cardamom. And these devices are devices designed to measure artery pressures in the pulmonary artery and we can judge what the patient's baseline should be. These measures are then transmitted to our office through a pillow which the patient sleeps on through bluetooth. So every day we get a downloading of the patient's harmony, arctic pressures that helps us multiple days before they can even have symptoms to know if there's a trend in the wrong direction as far as their heart failure. So we can treat the heart failure proactively. We are very fortunate that we have recruited some specialists in structural heart over the last year or two who have done additional training. Just focus on structural heart structural heart for those of you don't know that field. Since it is so new, it's using nonsurgical means to replace an aortic valve such as a tavern. We can place a prosthetic valve through the leg artery in the aortic valve position in place of doing open heart surgery to replace the valve. We can also do what we call mitra clips. These are clips that we place on the mitral valve leaflets to prevent regurgitation of blood across the valve when the valve is closed, it should not regurgitate blood. So what we do is play a little clip to help clip it together rather than replace the valve itself, structural specialists also work on fixing holes in hearts such as a stds or atrial septal defects or ventricular septal defects or V. S. Ds. There are some new horizons that we are currently working on and that's looking at placing clips on the trick. A spit valve which is another valve in the heart. So hopefully with all these newer technologies we can make the patient's recovery a lot easier. Oftentimes doing open heart surgery is not the surgery itself but it's the collateral damage that takes to get to the valve to fix it so we can avoid all those by doing those through an artery. It would be much safer or vein it'll be much safer for the patient long term. This also works in conjunction with electrophysiology doctors where they implant defibrillators. But many of these defibrillators now have newer devices in them as well. And we use these kind of edge devices that in the leads of the defibrillator. We can also measure the pressures and we can use what we call artificial intelligence. With these algorithms we develop To determine whether patients can develop heart failure 5-7 days before they even have symptoms. So we can address all these issues and prevent readmission. R. E. P. Doctors also do all types of ablation from S. VT. Ablation is not super ventricular tachycardia. Two ventricular populations. We do them from inside the heart. We also do what we call epic are really from outside the heart. So we're very very progressed and advanced in that area and really can offer really cutting edge therapies by taking all of these new innovations in conjunction with the availability of the heart hospital accountable care units And providing patient accessibility. On the outpatient side, we've been able to reduce our readmission rate um to less than 15% this year, Where national averages close to 30%. Why should you refer your patients to prisma health? Because we care we care about our patients and we have compassion. The ability to provide cutting edge technology and combine that with compassion is a very powerful tool to take good care of patients. And I think that at Prisma Health we do that well. And I think that you can rest assured that we will take good care of your patients that you refer. Or if you're a patient will take good care of you or if you're a patient's family will take good care of your family member.