YOUNGSTOWN Cardiac surgeon brings his care strategies to St. E's

His goal is a consistent, high level of care for heart patients.
By WILLIAM K. ALCORN
VINDICATOR HEALTH WRITER
YOUNGSTOWN -- Dr. Nicholas Cavarocchi, nationally known heart surgeon and medical director of cardiac surgery at St. Elizabeth Health Center, is implementing a system of care at the local hospital that improved the mortality rate associated with heart surgery at his previous hospital.
Before coming to St. Elizabeth's six months ago, Dr. Cavarocchi was regional director of cardiothoracic services and chief of cardiothoracic surgery at Mercy Hospital in Scranton and Wilkes-Barre, Pa.
Cardiothoracic surgery involves surgery of the heart and large blood vessels, lungs, bronchial tubes, esophagus, upper stomach, and supporting structures such as the ribs and muscles of the chest wall.
While at Mercy, he helped achieve an overall death rate of 0.97 percent for cardiothoracic patients, with two years of zero percent mortality. He was named one of the country's top surgeons in the 2002-03 edition of the Guide to America's Top Surgeons.
Dr. Cavarocchi said he was hired to achieve the same type of mortality results in heart surgeries at St. Elizabeth's, as well as bring his expertise in single and multiple heart-valve disease surgery to augment what he described as an "already strong" heart program.
Several firsts
In 1985, Dr. Cavarocchi helped develop a solution that preserves lungs for transplant for several hours, making more heart-lung transplants possible.
Also in 1985, he performed the first heart-lung transplant in which the donor and recipient were not in close proximity. Before development of the solution, it was impossible to preserve lungs long enough to transport them for transplantation. As a practical matter, the donor and recipient had to be in the same hospital or very close by, he said.
The breakthrough solution enabled distance transplants, thereby making more donors available and lung transplants more common, he said.
Dr. Cavarocchi said there are some new ideas are developing about treating congestive heart failure surgically, which he said he plans to implement at St. Elizabeth's. Currently, medication is used to treat most congestive heart failure, a condition in which the heart cannot pump out all of the blood that enters it, leading to an accumulation of blood in the vessels and fluid in the body tissues.
Promoting teamwork
He also will apply his organization skills to standardizing cardiac surgical techniques and treatment procedures throughout the entire hospital.
At present, St. Elizabeth's cardiac program consists of individual surgeons who practice at the hospital. The idea, Dr. Cavarocchi said, is to bring the individual cardiac surgeons together as a team.
One goal is to maintain consistent, high levels of care for patients at St. Elizabeth's no matter which doctor they get, Dr. Cavarocchi said.
A second goal is to convince area residents and their cardiologists that they don't have to leave the area to get the best care.
There is a lot of expertise that local residents are missing, and if they go to Cleveland or Pittsburgh, they may be seeing the most junior physician available, not the head of the department, he said.
Dr. Cavarocchi said that within a year the framework will be in place at St. Elizabeth's to achieve the same type of results as at Mercy Hospital.
alcorn@vindy.com