Heart and Vascular Institute – Treatment and Management of Cardiovascular Disease
Conditions of the heart, veins or arteries may take a multifaceted approach. Our team will work with you and your primary care doctor to create a treatment and management plan tailored to your needs and preferences.
Make an appointment
To schedule an appointment at any Penn State Heart and Vascular Institute location, please call
Depending on your condition, your options may include surgery, lifestyle changes or medication. The Penn State Heart and Vascular Institute brings together the care and services you need to heal and manage your condition so you can live your best life.
Our cardiothoracic surgeons are at the top of their field and work with the rest of our heart and vascular team to offer a full range of surgical options for treating cardiovascular disease. Types of cardiothoracic surgery we offer include:
- Arrhythmia surgery
- Coronary artery bypass (CABG) surgery
- Heart valve repairs and replacements
- Reoperative cardiac surgery
- Surgical treatment of adult congenital heart disease
- Thoracic aortic surgery
- Surgical therapy for heart failure
Heart and Vascular Institute cardiothoracic surgeons perform a variety of surgical procedures to treat heart rhythm disorders, including:
- Ventricular tachycardia, a rapid heartbeat that starts in the heart’s lower chambers
- Supraventricular tachycardia, a rapid heartbeat that starts in the upper part of the heart
- Atrial fibrillation, also called flutter, a rapid and irregular heartbeat that can increase risk for stroke. It’s often treated with the MAZE procedure, a surgery that creates scar tissue to block the signals causing irregular heartbeat. The surgery can be open or minimally invasive, depending on your condition and needs.
Coronary artery bypass graft (CABG) surgery
CABG is commonly called a bypass. This surgery is used when blood flow to the heart is blocked because arteries are clogged with a fatty substance called plaque. The surgeon takes a healthy piece of vein from the leg or artery from the chest or wrist. Then the surgeon attaches it to the coronary artery, just above or the below blocked area. This allows blood to go around the blockage. Our experienced surgeons offer multiple approaches to this surgery including:
- On pump
- Off pump
- Arterial conduits
- Endoscopic harvesting of saphenous veins and radial artery conduits
Heart valve repairs and replacements (mitral, aortic and tricuspid valves)
Heart valves control blood flow through the blood vessels. When a heart valve is diseased or damaged, it can block blood flow or cause leakage. The cardiothoracic team works with you to find the best solution for you. Our surgeons are skilled in heart valve repair and replacement procedures, including the:
- Open, standard technique, often used when a valve repair or replacement is performed along with bypass surgery.
- Minimally invasive technique, which does not require cutting open the chest. This option can offer a shorter hospital stay, quicker recovery, less pain and a smaller incision.
- Transcatheter aortic valve replacement (TAVR), using a flexible tube called a catheter to place the new valve inside of the existing valve. This option is for those who have aortic stenosis (narrowing of the aorta) and who are high risk for open surgery. Our surgeons, interventional cardiologists, imaging cardiologist and a nurse coordinator will work together to decide whether you need this procedure.
Reoperative cardiac surgery
If you’ve already had cardiac surgery, another one can bring new risks and challenges. Our team has the experience and knowledge to face these challenges, reduce risks and help you heal properly.
Surgical treatment of adult congenital heart disease
Cardiothoracic surgeons work closely with cardiologists in the care and treatment of adults who are living with congenital heart disease. Adult congenital heart conditions that are typically treated surgically include:
- Hypertrophic cardiomyopathy, thickening of the heart muscle. Surgery to remove part of the muscle is called myectomy.
- Atrial septal defect, a problem with the wall between the heart’s upper chamber and left and right atrium. Repair can often be minimally invasive, but open surgery may be needed.
Thoracic aortic surgery
Aneurysms (bulges), valve problems and other complex aortic conditions can be repaired through thoracic (chest) aortic surgery, such as:
- Aortic root replacement, replacing a section of the aorta and the valve
- Aortic arch replacement, replacing the bent section that connects the ascending and descending aorta
- Valve-sparing aortic root replacement, removing a section of the aorta and reconnecting the rest of it to the valve
- Descending aortic repairs, to treat problems in the part of the aorta that goes down toward your lower body
Vascular and endovascular surgery
Circulation of blood through the body is essential to life. Blood flows throughout the body through blood vessels (arteries and veins) that make up the vascular system. Diseases or damage to veins or arteries can keep them from circulating blood properly. This causes a lack of oxygen, called ischemia that can damage organs and tissues.
Cardiovascular disease affects the vessels of the heart. Peripheral vascular disease (PVD) affects blood vessels in your extremities.
Atherosclerosis is the underlying cause for narrowing of the arteries. It can affect any vessel, but most commonly involves:
- Aorta (the body's main artery)
- Arteries to the brain (carotid)
- Arteries to the kidneys (renal)
- Blood vessels in the legs
Vascular surgery uses traditional surgery as well as endovascular (minimally invasive) procedures to treat conditions of the arteries and veins.
Some of the procedures our endovascular surgeons commonly perform include:
- Endovascular repair of abdominal aortic aneurysm (EVAR)
- Endovascular repair of thoracic aortic aneurysm (TEVAR)
- Hybrid repair of abdominal and thoracic aortic aneurysm
- Open repair of abdominal aortic aneurysm (AAA)
- Carotid endarterectomy
- Carotid artery stenting
- Endovascular management of peripheral arterial disease (PAD)
- Lower extremity bypass surgery
- Mesenteric, renal artery stenting
- Mesenteric artery bypass
- Renal artery bypass
- Endovenous ablation for venous insufficiency
- Subclavian artery bypass and reconstruction
- Dialysis access
Surgical therapy for heart failure
Our heart failure team is skilled and experienced in surgical options for end-stage heart failure, including:
- Heart transplantation. Our heart transplant team is skilled and respected, and Penn State offers services to help you and your family cope with the challenges of the surgery and life after transplant.
- Left ventricular assist devices (LVADs) as destination therapy (long-term treatment), as well as bridge-to-transplant. Devices available for implant include:
- Thoratec® HeartMate II®
- Thoratec® HeartMate 3™
- Syncardia Total Artificial Heart
Extracorporeal membrane oxygenation (ECMO)
ECMO uses a machine to circulate oxygen-rich blood through the body while bypassing the heart and lungs. It’s used for acute respiratory failure or acute cardiogenic shock (when the heart suddenly can’t pump enough blood to meet the body’s demands). Our surgeons place the ECMO components, and our intensivist team will manage your follow-up care.
Heart failure program
If you’re one of millions of Americans living with heart failure, we can help. The Heart and Vascular Institute brings together a full range of services for the management and treatment of heart failure. We’ll work with you to provide the most convenient and effective care possible at all stages, including transplant, pacing and mechanical pumping assistance.
Our program has been recognized for quality of care by the Joint Commission and the American Heart Association. To make an appointment, please call 877-467-7484.
- What is heart failure?
- Heart failure care at all stages
- Living with heart failure
- Pacing and defibrillation therapies
- Advanced therapies for those with end stage heart failure
- Heart failure team
Heart failure, [link to http://pennstatehershey.adam.com/content.aspx?productId=108&pid=1&gid=000158] also called congestive heart failure, means the heart is not able to pump oxygen-rich blood out of the heart and to the rest of the body. Heart failure can be caused by:
- Coronary artery disease, or not enough blood flow to the heart muscle.
- Chronic high blood pressure that, over time, has stiffened the left main pumping chamber (ventricle) of the heart.
- Irregular heart rhythms, such as atrial fibrillation, where the upper chambers of the heart (atrium) are beating much faster than the lower chambers (ventricles). This keeps the blood from flowing swiftly out of the heart to the rest of the body.
- Faulty heart valves, that either don’t close properly (regurgitation) or don't open well (stenosis).
Talk with your health care team about the cause of your heart failure and what steps you should take.
Learning you have heart failure can be overwhelming. You and your family need one-on-one guidance tailored to your diagnosis and needs. Our team works with you to adjust your medication and treatment plan for the best results.
Our heart failure cardiologists will assess your condition and needs, and may offer you the option to enroll in clinical trials of new and promising treatments. We’ll monitor your progress and condition to make sure the treatment plan is working.
We may recommend cardiac rehabilitation, a tailored approach that draws expertise from physicians, nurses, exercise physiologists and registered dietitians.
Whatever your needs, our specially trained nurse practitioners will work with you, your caregivers and your doctors to create a complete plan of care. Your plan may include telephone management, remote electronic monitoring and scheduled clinic visits at convenient locations.
Your heart failure team works with other specialists in the Heart and Vascular Institute, including electrophysiologists (cardiologists who specialize in treating heart rhythm disturbances) and cardiac surgeons. You may see these and other specialists to treat symptoms of heart failure.
Heart failure is diagnosed by your doctor, but a number of tests are used to best understand your heart disease. Some tests may also be also be used to monitor your condition after starting treatment. Some of the tests you might need include:
- Echocardiogram, which uses sound waves to create a picture of your heart.
- Stress echocardiogram, which uses ultrasound imaging to show how well your heart is working.
- Nuclear thallium test, which uses radioactive materials called tracers to show the heart’s chambers.
- Electrocardiogram (ECG or EKG)
- Heart catheterization, passing a thin flexible tube (catheter) into the right or left side of the heart to see the heart and blood vessels or to treat certain heart conditions.
- Chest X-ray.
- Metabolic bike test, to see how well your heart and lungs work under stress.
You can live an active life, even with heart failure. The key is to work with your health care provider to manage your heart failure. Here are some guidelines:
- Monitor and record your weight daily. If you suddenly lose or gain a lot of weight, tell your doctor.
- Remember the symptoms of heart failure, and let your doctor know if you have:
- Weight gain
- Fatigue (often feeling tired)
- Swollen feet and legs
- Shortness of breath
- Bloated abdomen or stomach area
- Feeling of fullness after eating only a small amount
- Waking up at night with trouble breathing
- A cough that worsens when lying down
- Having to urinate more often at night
- Confusion or feeling mixed up
- Limit sodium (salt) to 2,000 milligrams or less a day.
- Take your medicine as directed, every time.
- Stay active and get plenty of exercise.
- See your doctor often so you can take care of any problems before they worsen.
If you have questions or need to contact your heart failure team, call 877-467-7484.
At some point, you may need a device to monitor and control your heart rhythm or to coordinate your heart function. Your options might include:
- Cardiac resynchronization therapy (CRT) biventricular pacemaker. This device is implanted under the skin by an electrophysiologist and helps coordinate the heartbeat and relieve symptoms.
- Defibrillator. This device delivers electric jolts to the heart to stop dangerous heart rhythms.
If your heart failure gets worse and does not respond to medical therapy, our team provides the latest proven surgical options and a level of care that is unmatched in the region. We’ve designed a care process that can be tailored to your needs and life, from pre-surgery appointments through recovery and long-term transitional care.
Our surgeons are skilled in surgical treatments, including:
- Total artificial heart
- Heart transplant surgery
- Ventricular assist device (VAD), a pump that can be used as a short-term bridge to transplant or as destination therapy (a long-term solution).
Our team in your corner
To give you the best possible care and support, our heart failure team includes:
- Advanced intervention care coordinators
- A cardiology-specific pharmacist
- A cardiology-assigned chaplain
- Clinical research coordinators
- A palliative care coordinator
- A social worker
- Transitional care coordinators
An arrhythmia (irregular heartbeat) can have many causes and be challenging to treat. Our electrophysiology team specializes in the heart’s electrical system and in treating and managing heart rhythm problems. As world leaders in treatment, research and national medical organizations, they’ve helped create care guidelines that are used nationwide. Our electrophysiologists are skilled in the latest proven techniques, and can often offer access to leading clinical trials of new and promising treatments.
Abnormal heart rhythms can be treated with medication, ablation (creating scar tissue to block the signals causing arrhythmia) or implanted devices such as pacemakers and defibrillators. Procedures are performed in our electrophysiology laboratory using equipment that can map the heart's electrical circuitry.
Some of the services we offer include:
- Electrophysiology studies to see how well the heart’s electrical system is working.
- Routine checks for pacemakers or implantable cardioverter defibrillators (ICDs). A specialist in these devices reprograms them as directed by our doctors. We also offer remote monitoring.
- Atrial fibrillation ablation
- Catheter ablation, creating scar tissue to block electrical signals causing arrhythmia.
- Placement of pacemakers
- Placement of implantable cardioverter defibrillators (ICDs)
- Cardiac resynchronization therapy (CRT)with a biventricular (BiV) device, which paces both the right and left ventricles of the heart at once.
- Managing and removing device leads as needed.
- Tilt table testing to find the cause of syncope, or fainting.
- Treatment for long QT syndrome and other disorders that can affect heart rhythm.
Atrial fibrillation management using the Watchman™ (including Watchman left atrial appendage closure), reduces the risk of stroke without long-term blood thinner.
The Watchman device is a newly approved left atrial appendage closure for those with non-valvular atrial fibrillation (a-fib). This device reduces the risk of stroke and the need for patients to take long-term blood thinner medications.
Those with this type of a-fib are at an increased risk of having a stroke, due to blood settling in the left atrial appendage, potentially clotting and traveling through the body to the brain.
The umbrella-like device is implanted into a patient’s heart, through a catheter (tube) and acts as a screen to close off the left atrial appendage, allowing blood to continue to flow out of the left atrial appendage, trapping any clots.
Penn State Heart and Vascular Institute offers a multi-disciplinary team to evaluate patients for the device, perform the implant procedure and continue to care for patients following the procedure.
For more information about Watchman:
General cardiology and prevention
Services provided by the General Cardiology and Prevention program include:
- Congestive heart failure
- Heart transplant
- Adult congenital heart disease
- Wellness, prevention and rehabilitation
- Interventional services
Interventional services, including interventional cardiology and cardiovascular interventional radiology, can help treat a wide range of conditions and disease. Our Cardiovascular Interventional Radiology team offers advanced imaging aimed at diagnosing and treating peripheral vascular disease as well as a host of non-vascular pathology.
The interventional cardiology program offers advanced, minimally invasive treatment options for cardiac and vascular diseases. Some examples include:
- Cardiac catheterization uses a catheter (a thin flexible tube) to view the arteries and check the heart’s structure and function.
- Coronary (balloon) angioplasty and stent placement uses a catheter with a tiny balloon on the end to open an artery and place a stent (a tiny, mesh-like tube) to keep the artery open.
- Intravascular ultrasound uses sound waves to see inside the heart and blood vessels.
- Valvuloplasty uses a balloon to fix narrowed or stenotic heart valves.
To make an appointment, call 877-467-7484
Cardiovascular interventional radiology
Wellness, prevention and rehabilitation
Hospital to Home (H2H) National Quality Improvement Initiative
The right care after you leave the hospital could make all the difference to your future health and quality of life. Hershey Medical Center is a participating hospital in the Hospital to Home (H2H) National Quality Improvement Initiative, led by the American College of Cardiology and the Institute for Healthcare Improvement. This initiative aims to reduce hospital readmissions and smooth the move from hospital to home after hospital treatment for heart disease.
This initiative has three areas of focus:
1. Medication management
Do you have your medications? Do you know when to take them and why you need them?
If your doctor has prescribed medicine to treat your heart disease, it’s critical to take them as directed. Make sure you understand when, how much and how to take them. Keep in mind:
- Some medicines need to be taken at certain times of the day.
- Some medicines may interact with others you are already taking or with certain foods.
- If are having trouble paying for your prescriptions, a prescription assistance program coordinator can help.
2. Symptom management
Do you know the signs and symptoms that need medical attention and who to contact if they occur?
Make sure you know what to do if your symptoms return. Talk to your doctor and health care team now, so you’ll know:
- Which symptoms require medical attention
- Whom you should contact for help
- When you should call
- When you should get emergency care
3. Early follow-up
Do you have a follow-up visit scheduled within seven to 10 days of discharge? Do you have a way to get there?
Research has shown you’re less likely to need another hospital stay when you have a follow-up appointment within seven to 10 days after discharge from the hospital.
We will schedule an appointment for you before you leave. At the appointment, one of our physician assistants or nurse practitioners will meet with you to:
- Make sure you understand your medications and how to take them
- Find options if you cannot afford your medications
- Make sure you know your action plan and what to do if you have symptoms
If you are can’t keep this appointment, call the Penn State Heart and Vascular Institute Access Center at 877-467-7484 to reschedule. If you need transportation, let us know before you leave the hospital and an inpatient social worker can help.