John P. Cheatham, MD, Delivers SCAI Mullins Lecture on Hybrid Procedures

May 5, 2011—John P. Cheatham, MD, delivered the keynote Mullins Lecture at the Society for Cardiovascular Angiography and Interventions (SCAI) 2011 scientific sessions in Baltimore, Maryland. Dr. Cheatham described how hybrid procedures combining the disciplines of interventional cardiology and cardiac surgery are resulting in stronger and more adaptable approaches in the treatment of birth defects of the heart.

“Nowhere is the bond between the interventional cardiologist and cardiothoracic surgeon more solid than in the treatment of complex congenital heart disease,” stated Dr. Cheatham said. “We have a ‘one team' philosophy in congenital heart disease.”

According to SCAI, Dr. Cheatham directs cardiac catheterization and interventional therapy and is Co-director of The Heart Center at Nationwide Children's Hospital in Columbus, Ohio. He was introduced to hybrid procedures in 1999 when he and Mark Galantowicz, MD, now Chief of Cardiothoracic Surgery at Nationwide Children's Hospital, began working together to establish a new heart center in Orlando, Florida. During construction, all cardiac catheterization procedures were performed in the surgical suite. Working in close proximity gave each physician a better appreciation for the strengths and obstacles of treating complex congenital heart disease with surgical and interventional techniques.

“Out of this mutual respect came the idea that it would be easier and perhaps improve patient outcomes to combine the scalpel with specialized catheters and devices,” commented Dr. Cheatham.

Initially, hybrid procedures focused on treating babies with undersized chambers on the left side of the heart. Open surgery was used for one step of the procedure, catheter-based stenting for another—all without the use of the heart-lung bypass machine. Over the years, he noted, many new hybrid procedures have evolved, including a less traumatic way to treat large holes in the wall between the right and left ventricles.

Today, interventional cardiologists also help to detect and treat narrowed arteries that can sometimes develop after congenital heart surgery. High-risk patients routinely have “exit angiography” before leaving the hybrid cardiac operative suite, immediately followed by stenting of the narrowed artery if needed.

“As long as there is a spirit of collaboration between the specialty services, we believe that there is no limit to the future of hybrid therapy,” concluded Dr. Cheatham.