Spring 2014
The next generation of cardiac surgery

Bridgeport Hospital has a reputation for advanced cardiac care. It’s a record of innovation that dates back to the early 1960s when surgeons there performed Fairfield County’s first open heart surgery, pacemaker implant and cardiac catheterization.

Today, the cardiac surgery program at the hospital’s Joel E. Smilow Heart Institute adds to this legacy by integrating with Yale-New Haven Hospital (YNHH) and Yale School of Medicine to provide the most advanced patient care possible.

“Patient access to both Yale-New Haven Hospital and Bridgeport Hospital provides them with the best of what each institution offers,” said Umer Darr, MD, chief of cardiothoracic surgery at Bridgeport Hospital and assistant professor of surgery at Yale School of Medicine. “Centralizing care this way also improves patient outcomes.”

Umer Darr, MD, (left) and Michael Dewar, MD, are developing a major university-level, high-quality cardiac program at Bridgeport Hospital while maintaining its community hospital feel.

Working with Dr. Darr is Michael Dewar, MD, cardiovascular surgeon, also an assistant professor of surgery at Yale School of Medicine. “Being part of a university practice enables us to become familiar with the latest medical procedures and gain the training and expertise to perform them at Bridgeport Hospital,” noted Dr. Dewar.

Advanced procedures
One example is transcatheter aortic valve replacement (TAVR), an advanced procedure for patients with severe aortic stenosis (narrowing of the aortic heart valve) who don’t qualify for open heart surgery. “We evaluate patients for TAVR at our new Bridgeport Hospital clinic and perform the procedure at Yale-New Haven Hospital,” explained Dr. Darr.

Another is use of a ventricular assist device (VAD) that pumps blood from the heart to the rest of the body. VADs can be used short-term or long-term, depending on the patient’s condition. ECMO (extracorporeal membrane oxygenation) is a special VAD system YNHH uses for lifethreatening heart and/or lung problems. Yale New Haven Health System (YNHHS) hospitals are among the few in the state with this expertise.

Add the fact that Dr. Dewar is one of New England’s most experienced surgeons in off-pump coronary artery bypass, which improves blood flow to the heart of patients with severe coronary disease, and you see how collaboration with YNHH and Yale School of Medicine is transforming Bridgeport Hospital and its Joel E. Smilow Heart Institute into a major university-level, high-quality cardiac surgery program while still maintaining the feel of a community hospital. The latter is a key factor that led Gail Scholan, 76, to choose Dr. Darr and Bridgeport Hospital for her valve replacement surgery.

“Dr. Darr operates at both Yale-New Haven and Bridgeport hospitals, so that was important to me,” said the Fairfield resident. “I have had many procedures at Bridgeport Hospital and feel really good about it.”

Her outcome proved she made the right choice. “Dr. Darr was absolutely spectacular at putting my mind at ease and everything was surprisingly easy.” The next day Gail was sitting up and talking on the phone and by the second day she was walking, keeping her “record” unblemished. “I’ve never had a bad experience at Bridgeport Hospital.”

Gail’s experience echoes Dan Zimmerman’s, 78, whose double valve-replacement surgery Dr. Dewar performed. “My cardiologist told me that Dr. Dewar had wonderful hands,” recalled the Stratford resident, a statement confirmed by the results of Dan’s surgery and return to health.

Bridgeport Hospital’s affiliation with Yale-New Haven Hospital was a major factor in Dan Zimmerman electing cardiac surgery there.

Bridgeport Hospital’s affiliation with Yale-New Haven Hospital also factored into Dan’s decision. “That was a plus for me. It made me feel more comfortable.” So did his previous experience at Bridgeport Hospital through his wife Bella’s hip replacement surgery and other care there. Bottom line: “Based on my experience with other hospitals, I felt Bridgeport Hospital was a good choice.”

World-class vision
While Gail’s and Dan’s results reflect the cardiac surgery staff’s immediate goal of high-quality care, their long-term reach is much higher. “We want Bridgeport Hospital to partner with YNHH in growing a cardiac surgery program that is world-class in scope and depth, with a reputation as an outstanding teaching venue,” said David Yuh, MD, who as chief of cardiac surgery at YNHH and Yale School of Medicine, and surgical director of the YNHH Heart and Vascular Center, oversees the joint program and its growth.

“Our goal is to create a unified cardiac surgery system across Bridgeport Hospital and YNHH,” he added. “We see Bridgeport Hospital as a vitally important campus of YNHHS where cardiac surgery is performed as well as at YNHH.”

“Bridgeport Hospital always performed conventional cardiac surgery procedures. It is the broad range of surgery procedures now offered as a result of our collaboration with YNHH that makes our program unique among Connecticut hospitals,” added Dr. Darr. This follows the successful integration path taken by Bridgeport Hospital’s pediatric services and Yale-New Haven Children’s Hospital in early 2012, expanding the pediatric services available to Bridgeport-area patients.

Bridgeport Hospital’s joint cardiac surgery program with YNHH will enable the two staffs to build on their expertise and grow as part of Yale New Haven Health System. “Integrating the two cardiac surgery programs is also the first concerted effort to bridge many of the surgical services at both campuses,” added Dr. Yuh.

For the immediate future, the cardiac surgery program at Bridgeport Hospital’s Joel E. Smilow Heart Institute will focus on enhancing its already high-quality care, noted Dr. Darr. “We’ll measure our success objectively against patient feedback, surgical outcomes and other related data.” This will take time, he added. But Dr. Darr is confident that “By increasing provider access to patients and sharing our expertise, this symbiotic relationship will benefit everyone.”

As Dr. Darr pointed out, “Bridgeport Hospital already packs a bigger punch than other hospitals of our size. Think of the advantages to area residents as this joint Bridgeport Hospital-YNHH cardiac surgery program grows.”

Cardiac procedures at Bridgeport Hospital

Bridgeport Hospital offers expertise in a wide range of cardiac procedures not available at many other area hospitals. These include:

  • The David procedure
    This procedure replaces the root of the aortic valve while preserving the valve. It is named after Dr. Tirone David, who developed the technique at Toronto General Hospital.
  • Extracorporeal membrane oxygenation (ECMO)
    The ECMO life-support system is used for lifethreatening heart and/or lung problems. The ECMO machine adds oxygen to the blood and removes carbon dioxide, enabling the sick heart and/or lungs to rest and heal.
  • Hybrid ablation
    This treatment is for patients with persistent and longstanding irregular heartbeat (atrial fibrillation). It combines surgery and catheter ablation to eliminate the electrical “signal” causing the irregular heartbeat.
  • Minimally invasive direct coronary artery bypass (MIDCAB)
    Using a small incision in the chest wall, this minimally invasive heart surgery includes a coronary bypass on a blood-filled beating heart without a heart-lung machine.
  • Minimally invasive mitral valve repair/replacement
    The mitral valve lets blood flow from the lungs into the left side of the heart and keeps it moving forward. A mitral valve that doesn’t function properly may require repair or surgery. This is performed through smaller cuts than traditional surgery.
  • Off-pump coronary artery bypass (OPCAB)
    OPCAB is a type of minimally invasive cardiac surgery that avoids cardiopulmonary bypass so the heart can continue to beat during surgery, but the entire heart is exposed for multiple bypasses to more than one coronary artery.
  • The Ross procedure
    This replaces a diseased aortic valve with the patient’s pulmonary valve. The pulmonary valve is replaced with a donor’s pulmonary valve.
  • Transcatheter aortic valve replacement (TAVR)
    The TAVR procedure places a valve into the aorta, the heart’s main artery, using a thin tube called a catheter. This less-invasive treatment option is an alternative for patients who do not qualify for open-heart surgery, especially those who are too weak or sick.
About our cardiac surgeons

Umer Darr, MD, chief of cardiothoracic surgery at Bridgeport Hospital, received his medical degree from Aga Khan Medical College, Karachi, Pakistan. He completed his general surgery residency at the University of Connecticut School of Medicine and his cardiothoracic fellowship at Yale University and Toronto General Hospital.

Michael Dewar, MD, graduated from the University of Massachusetts Medical School. He completed his general surgery and cardiac training at McGill University, Montreal, Canada, and a one-year pediatric fellowship at the Hospital for Sick Children, Great Ormond Street, London, UK. He is a fellow of the American College and the Royal College of Surgeons and president of the Almazov Foundation of North America, dedicated to training advanced cardiac specialists in Petersburg, Russia.

David Yuh, MD, chief of cardiac surgery at Yale-New Haven Hospital and surgical director of the YNHH Heart and Vascular Center, received his medical degree from Stanford University School of Medicine. He completed his residencies in general and cardiothoracic surgery at Stanford University Hospital, and his residency in cardiothoracic surgery at Stanford University Hospital.

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