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At the Hospitals

n Hybrid Ablation Offers Atrial Fibrillation        hope to patients with rare forms of hepatic (liver)  and attended the University of Southern California
                                                    cancers. A 25-member team has joined two             Keck School of Medicine. He completed his
  Patients Another Option                           previously described methods of treatment in a       general surgical residency at the University of
                                                    groundbreaking new combined procedure.               California Riverside and his cardiothoracic
  Patients with persistent and long-standing                                                             surgery residency at Temple University. Most
persistent atrial fibrillation (AF) who have a        According to Dionisios Vrochides, MD,              recently, Mitchell completed his general thoracic
higher risk for stroke or heart failure may now be  PhD, FACS, with Atrium Health’s Department           surgery fellowship at the Mayo Clinic.
candidates for an innovative procedure available    of Surgery and Levine Cancer Institute, the
at Atrium Health’s Sanger Heart & Vascular          procedure is used in patients whose cancers            Andrew Kott, MD, joins Sanger as a
Institute. Called hybrid ablation, the procedure    have favorable biology but have technical hurtles    cardiologist. Dr. Kott attended the University
combines surgical and catheter ablation and         that, until now, prevented effective treatment. It   of Wisconsin for his undergraduate studies
reduces complications, shortens recovery time       combines the Ex Vivo technique, which removes        and Northwestern for medical school and
and has significantly better success rates than     the liver, extracts the cancer and transplants the   residency. He completed his cardiology
catheter-based ablation alone and is less invasive  liver back into the patient, with the ALPPS          fellowship at Vanderbilt and completed a
than traditional surgical ablation.                 treatment, which splits the liver and allows the     cardiac MRI and advanced imaging fellowship
                                                    organ to regenerate within the body.                 at the Medical College of Wisconsin, where
  Sanger’s hybrid ablation team is headed                                                                he was a member of the faculty. Kott will be
by Jeko Madjarov, MD, cardiothoracic                  This innovative procedure is only possible         seeing patients at Atrium Health’s Carolinas
surgeon and Sherry Saxonhouse, MD,                  for a small number of patients. About one out        Medical Center, where he will focus on
electrophysiologist. The procedure is a great       of 20 evaluated patients become eligible for the     advanced imaging.
option for patients with long-standing persistent   surgery. But for those with rare forms of locally
AF who have failed medical therapy and repeat       advanced liver cancer, or those who have once          Pramesh Dhakal, MD, joins Sanger’s Division
ablations. During the procedure, Drs. Madjarov      been told nothing can be done due to technical       of Adult Cardiology. Dr. Dhakal completed
and Saxonhouse work together in a hybrid            reasons, the Ex-Vivo-ALPPS procedure                 his internship and residency at State University
ablation room to perform the ablation from          restores hope.                                       of New York Upstate Medical University in
inside the heart (endocardial) and outside of the                                                        Syracuse, where he also completed a chief
heart (epicardial).                                 n Sanger Heart & Vascular Institute                  residency and fellowship in cardiovascular
                                                                                                         disease. He is based in Monroe with an advanced
  Combining the procedures means patients             Welcomes New Physicians                            imaging focus in echo, nuclear and computerized
only go through anesthesia and recovery once.                                                            tomography (CT) scans.
Patients typically go home within two to three        Mark Mitchell, MD, joins Sanger’s thoracic
days and experience less pain and scarring than     surgery team and will be working in partnership        Appointments with Sanger physicians may
if they undergo surgical ablation. Hybrid AF        with Levine Cancer Institute-Pineville. Dr.          be made by visiting https://atriumhealth.org/
ablation has been shown to have better results      Mitchell completed his undergraduate degree in       sangerheart.
for patients with long-standing persistent AF.      bioengineering at the University of Pennsylvania
The success rate of catheter ablation is around
40 to 50 percent. With hybrid ablation, up to       n Pediatric Emergency Room Opens in Lake Norman
80 percent of patients achieve normal sinus
rhythm. And one study reported that 79              Atrium Health Levine Children’s has opened a new emergency room in Lake Norman. Located
percent of hybrid ablation patients remained        inside the Atrium Health Huntersville Emergency Department, a facility of Atrium Health
arrhythmia-free after three years.                  University City, the space combines expert emergency care with a child-focused environment.
                                                    It is the only pediatric emergency care location in Lake Norman with trained specialists who
  Sanger is the only center in the region offering  are fully supported and backed by Levine Children’s Hospital, which has been nationally
this procedure. The team has performed more         ranked as a best children’s hospital for each of the 12 years it has been open. In addition to
than 20 hybrid AF ablation procedures to date,      traditional emergency medicine services, the facility comes with:
and all but two of those patients had earlier       • 24/7 healthcare providers who are specially trained in caring for children
interventions that failed. Today, every patient is  • Separate entrance and waiting room, plus a colorful, child-friendly setting
living arrhythmia-free.                             • Reserved parking spots, just for pediatric patients and their families
                                                    • Child-sized equipment to better and more comfortably treat children
n First-in-World Procedure for                      • Child life specialists who help children stay positive and brave during their visit
                                                    • Video games and activities for a fun, soothing distraction
  Liver Cancer                                      The new children’s emergency department can treat a full range of serious or life-
                                                    threatening illnesses, injuries and conditions, including asthma attacks, broken bones,
  A world-first procedure performed at Atrium       fevers, dehydration, flu, poisoning, swallowed objects, sprains, strains and more.
Health (Ex Vivo-ALPPS procedure) has given          Innovative telehealth technology enables the care team in Huntersville to instantly consult
                                                    with experts across Levine Children’s to discuss images and lab results and capture vital
                                                    assessment information in real time. If additional care is needed, immediate contact to
                                                    Levine Children’s Hospital in Charlotte or Jeff Gordon’s Children’s Center in Concord is
                                                    coordinated through MedCenter Air.

12 | February 2020 • Mecklenburg Medicine
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