Transcription:

Michael Carrese: Welcome to Inspiring Health, a series of conversations with Roxanna Gapstur and other WellSpan leaders about WellSpan 2025. I'm Michael Carrese and Roxanna, great to be with you again.

Dr. Roxanna Gapstur: Great to be with you. Michael.

Host: What are we going to be talking about today?

Dr. Roxanna Gapstur: February is heart month and so we're going to be talking about advances in heart and vascular care today.

Host: And who's our special guest?

Dr. Roxanna Gapstur: Our special guest today is Dr. James Harvey. He's the Medical Director of the Structural Heart Program at WellSpan and he's also an interventional cardiologist with WellSpan Cardiology in York.

Host: Great. So why don't you start by telling us a little bit about heart month and what does WellSpan had planned around that?

Dr. Roxanna Gapstur: Heart month is one of those times during the year when we really like to share our commitment with our community in terms of improving health. And so we have several free public events planned in each of our communities. We have an internal campaign for our employees and also some public facing messaging about heart health. We also like to give a timely platform to raise awareness about heart disease and how to keep your heart healthy. And so we'll use heart month to do that as well as celebrate our heart and vascular teams across our organization.

Host: So how prevalent is heart disease?

Dr. Roxanna Gapstur: Heart disease today is the number one killer of men and women in the United States. And 48% of people in the United States have heart disease. So those are some sobering statistics and makes it very important for us to focus on this type of care in our system.

Host: So why is it important for WellSpan to participate in heart month?

Dr. Roxanna Gapstur: Well, there's a few reasons. One, I would say, you know, our communities look to us for their care and so our ability to bring specialty care close to home for our communities is a really important part of who WellSpan is. Our services specifically at WellSpan York Hospital really make us a destination for cardiac care and I would say both a regional and national destination. It also allows us to recognize our heart and vascular team this month. And we just started using one of the world's first technologies right here in central Pennsylvania.

Host: Yeah. So Dr. Harvey want you to jump in and tell us about the new technology. What's it all about and why is it happening here in York?

Dr. James Harvey: We're lucky at WellSpan York hospital is home to the first hybrid 40 cat scan and state of the art catheterization suite. So what this means is that we're now able to do advanced non-surgical heart procedures with, you know, if we couple these two technologies, we can do it with greater accuracy, shorter procedure time, shorter workup. And what this translates to is less time in the procedure, less extra exposure for the patient, less contrast dye and ultimately greater safety and greater outcomes with a technology that's never been used before.

Host: And what kind of procedures are you talking about here?

Dr. James Harvey: The technology's fascinating. We have a really truly state of the art 40 cat scanner. And what a cat scanner is a device that takes multiple x-ray images to make a 3D reconstruction of an object such as a patient. And the fourth D is time. And so this is critically important because the heart beats and so it's a moving structure. And so you have to take these images moving over time. The heart muscle, the heart valves, the heart, you know, the blood and that sort of thing. When you take this and couple this with using a, with a cardiac catheterization suite. Traditionally we do this with a flat screen monitor. So we're doing this with x-ray and we're doing it in two dimension. So now you can imagine taking this and coupling this, taking a three dimensional object and coupling this. And now instead of looking at a flat screen like a television, I can do this, like I'm looking through three D glasses. As a result, you can see how you can do this with much greater accuracy. We can actually see the heart structures moving not just on x-ray, but actually a three-dimensional reconstruction as we do this. This is so unique in that this has been tried before in the past. But this has been limited because you can only get kind of centimeter accuracy if it's submillimeter accuracy. And now that we have them in the same suite, we can do this with greater accuracy than ever done before.

Host: So Dr. Harvey, you mentioned 4D, can you break that down for us?

Dr. James Harvey: And that's an excellent question. When we talk about a 40 cat scanner, the first three are the three dimensions we're talking about length, width, and height. But the trick to that is adding the fourth dimension, which is time. And so with a cardiac CT scan, because you know with other organs that aren't moving, it's not as vital, but with the heart, which moves, you know, if you're taking a picture of a moving object, it's blurry unless you can time it exactly right. So the fourth dimension is time. The vital importance of this is that we have an excellent state of the art cat scanner that can take these sequential images in time.

Host: So Dr. Harvey, why is this happening in New York for the first?

Dr. James Harvey: So when I came here about four years ago, we used to say we had the best kept secret on the East coast. But unfortunately it's not such a secret now. Truthfully, this isn't really surprising. I'm proud to say that the practice I joined has been pioneered by visionary leaders such as Dr. Jane Nicholson, who really many years ago changed the way we access the heart for nonsurgical procedures. More recently, Dr. Bill Nicholson has truly pioneered the way we fix complex coronary disease and percutaneous revascularization of blocked heart arteries. And I'm proud to be part of a team now that's continuing to forge the way with structural heart, meaning fixing the non vascular like valves and holes, and those kinds of problems in the heart and tradition. With our experience with WellSpan, when we realized that there was a great opportunity for this new technology, we brought it up to our administration and as always they support us and said, where can we help to help the patients of Southeast Pennsylvania?

Host: That's terrific. So you've got this fantastic technology. How are others going to tap in and learn about the groundbreaking work you're doing?

Dr. James Harvey: So with any new technology, it brings great opportunity, but it brings great responsibility. And so we recognize that, you know, each of these technologies in and of themselves, we are very familiar with, but it's the coupling of that we have to responsibly bring forward to help patient care. So fortunately we have an excellent research team that we have great collaboration with. And so, you know, what we typically do and what we've done in the past with this is we kind of get around a table and brainstorm on how can we take this to make care better? What do we have that can make care better? And then once we've come up with multiple protocols for this, which we've already started, then we bring them to what we call our institutional review board, which for those who don't know what that is, we have a group of people who are at, some are medically trained, some are not, some are from WellSpan, some are not.

And so we really kind of pose our questions and what we thought would be good and bad to a community of people who'd span all gaps to make sure that we're covering all angles and looking at all views from which. And so once we've come up with a protocol, we can agree, then we move forward. And so once we do that, we designed a database which now we are collecting all the data, regarding whether that's radiation use, dye use, what the outcomes are, what the time is, what the efficiency is. From that, we're really pulling a data set that we'll be using to publish these results and present them at national meetings and national papers. We've actually already have in the brief time we've had this, three papers have been written, we've already submitted two of them and one's already been accepted in a national publication.

Host: And how has it been going so far? Overall, how many cases have you done?

Dr. James Harvey: We've done about 60 or so, just diagnostic studies from there. We've done over 40 coupled studies meeting where we use the technology for what it's designed. We use the imaging, we overlay it with a procedure, whether it's a heart catheterization, a valve implantation, a left atrial appendage occlusion, these sorts of things. We've already been able to do about 40 of those and as you can imagine, you know, just in that amount of time we've already been able to see amazing procedural efficiencies and better accuracy and better diagnostic ability with this.

Host: Unbelievable. Roxanna, this is really exciting. Why is this type of investment important for WellSpan?

Dr. Roxanna Gapstur: As the leading regional health system in South central Pennsylvania, this is part of what we do for our communities. We bring state of the art technology to improve care and having specialty care close to home so that people don't need to travel really means that patients and families can trust us to do the very best for them. This type of technology and this kind of cardiovascular team are something that we are so proud of and we're looking forward to seeing all of the great things that are going to come out of the uses of these technologies. Specifically better outcomes for our friends and neighbors here in South Central Pennsylvania.

Host: So it is heart month and you guys are both providers. So we need some tips now on how to be healthy. And why don't you jump in first, Dr. Harvey, what's your top advice to patients about heart health?

Dr. James Harvey: Truth is that most things we know about being heart healthy are kind of age old things. It's long been known that most of us could do more activity and doing activity not only has been shown to lengthen your life, but equally or more important, to keep you functional for the remainder of your life. So you know, most of us know what to do. It's how to implement it. And so my advice to most people is if you're like me, I'll try to sit down once a week and say what three days of the week, no matter what happens, am I going to at least do 30 minutes of exertional activity? Now, doesn't have to be super exertional, just have mild to moderate activity. And that activity alone would dramatically change the health of our population.

Host: It doesn't take as much as people think. Right? A lot of folks I think are hesitant because they figure, well, I've got to start running marathons or something. But as you say, just three days a week, you can make a big impact.

Dr. James Harvey: That's exactly right.

Host: Roxanna, what would you say?

Dr. Roxanna Gapstur: Well, I usually try to get in additional steps every day, so I'm one of those people who would prefer to take the stairs rather than the elevator. And because I have kind of a sedentary job, I take every opportunity I can in between meetings to be able to walk around the building that I work in. And then when I traveled to other places, you know, parts of our communities where I don't go as often, I often look for places that I can walk outside, especially if the weather's nice. So I just try to as active as I can, knowing that my job is one that doesn't actually promote that very easily. And of course on the weekends I try to do some hiking and enjoy the beautiful South central Pennsylvania scenery.

Host: Well, we will have to wrap it up there. But you've been listening to Inspiring Health, the series of conversations with Roxanna Gapstur and other WellSpan leaders about WellSpan 2025. Roxanna's guest today was Dr. James Harvey Medical Director of the Structural Heart Program at WellSpan. And for more information on today's topic, please check out the heart month page on wellspan.org I'm Michael Carrese, thanks for joining us.