Hackensack University Medical Center Endovascular Surgeon Becomes First in US to Perform Commercial Minimally Invasive Thoracic Aortic Repair Using New Device

Newswise — HACKENSACK, NJ — On August 16, 2022, Michael Wilderman, MD, chief of Endovascular Surgery at Hackensack Meridian Hackensack University Medical Center, became the first in the US to perform a commercial minimally invasive repair of a Type B aortic dissection using the new GORE® TAG® Thoracic Branched Endoprosthesis (TBE) — marking the first time the device was implanted at a non-clinical trial site.

Cynthia (Cindy) Pecorelli, 62, of Belleville, New Jersey, was the recipient of the TBE.

“A few days after July 4, I felt severe pain in my upper abdomen and back — probably an eight or nine on a scale of 1-10,” said Cynthia. “It slowly went away, but when I went to the doctor the next day, he sent me to the emergency room.”

Cynthia was transferred from her local hospital to Hackensack University Medical Center, where Emergency Department physicians performed a CT scan, blood work and an ultrasound to diagnose her with a Type B thoracic aortic dissection. A Type B thoracic aortic dissection happens when a tear occurs in the inner layer of the portion of the aorta — the body’s main artery — that descends from the heart into the chest.

Innovative Treatment Options for a Complex Condition

Aortic dissection is a life-threatening condition that requires emergency evaluation and expert treatment. Dr. Wilderman is one of the most experienced physicians in the country in the treatment of aortic conditions, presenting his research at national and international meetings and training other physicians on the latest treatment approaches.

He offers a full range of treatment options for aortic conditions, with a focus on developing and utilizing innovative minimally invasive techniques to treat patients who are unable to undergo traditional open aortic repair surgery. As a result, Hackensack University Medical Center is a regional destination for comprehensive care of aortic conditions.

“As an early adopter who is expertly trained in the latest minimally invasive techniques to treat aortic dissection, Dr. Wilderman is one of the first physicians in the region to have access to the innovative Gore TBE device — which is the first and only commercially available, ‘off-the-shelf’ device designed to provide minimally invasive treatment of thoracic aortic conditions,” said Gregory Simonian, MD, director of the Cardiovascular Center of Excellence at Hackensack University Medical Center.

During the procedure, the TBE is inserted through a small incision in the groin. The TBE has a pre-made fenestration – or hole – that allows it to be placed across the arch of the aorta in the chest while still preserving blood flow to the branched artery that supplies the arm, brain and spinal cord.

Before the approval of the Gore device, surgeons either needed to perform a major bypass procedure to maintain blood flow to the arm, brain and spinal cord, or temporarily cut off blood flow altogether, which increases the risk of stroke. As a result, two operations were required to repair the dissection and restore blood flow to the branched artery. And although custom-made devices were available, they often took 4-5 weeks to make — which was too long of a wait for patients who needed emergency treatment.

“The Gore TBE contributes to improved outcomes by reducing operative time, length of stay and patient discomfort,” said Dr. Wilderman. “We can now treat thoracic aortic aneurysms using a single device in a single surgery performed through two small incisions in the groin and one in the wrist — with immediate access to the device, and without the need for open surgery.”

Minimally Invasive Care Delivers Outstanding Outcome

After stabilizing Cynthia’s condition during her Emergency Department visit, Dr. Wilderman determined that Cynthia did not need emergency treatment. Evidence showed the safest option was to allow Cynthia’s delicate aorta to “rest” for a few weeks to reduce the risk of complications during the aortic dissection repair.

“Performing surgery too soon or too late can lead to poor outcomes,” said Dr. Wilderman. “We have the experience to identify the optimal time to perform a procedure and the best approach to use for each patient.”

On August 16, 2022, Dr. Wilderman — in collaboration with Dr. Simonian and vascular and cardiac surgery colleagues — performed Cynthia’s procedure at Hackensack University Medical Center.

“In Cynthia’s case, Dr. Wilderman and his team applied experience, clinical evidence and effective initial assessment and treatment to optimize the patient before surgery,” said Dr. Simonian. “The team was able to convert an emergency to a semi-elective procedure, which provided outstanding results.”

“Cynthia went home the day after surgery and did very well,” said Dr. Wilderman. “With the support of a multidisciplinary team of cardiovascular experts, we were able to perform a ‘first-of-its-kind’ procedure right here in New Jersey, meaning that Cynthia didn’t have to travel far to receive the life-saving care she needed.”

“We are proud to have the expertise and access to the latest technology that allows us to offer our patients the latest treatment options — especially for a complex, life-threatening condition like aortic dissection,” said Mark Sparta, FACHE, president, Northern Region , and president and chief hospital executive, Hackensack University Medical Center. “We are a regional referral center for aortic dissection treatment, and we want our patients and referring physicians to know that they can trust us to offer the most advanced care.”

“Dr. Wilderman and our team members are among the nation’s leaders in treating complex aortic conditions, which means that Cynthia and others who develop this condition can turn to us for an accurate diagnosis, a comprehensive care plan and innovative treatment options,” said Ihor S. Sawczuk , MD, FACS, Hackensack Meridian Health’s president of Academics, Research and Innovation, and also associate dean of Clinical Integration and professor and chair emeritus of Urology at the Hackensack Meridian School of Medicine..

“I was a little nervous about the procedure, but Dr. Wilderman was very reassuring. He explained exactly what happened and what he was going to do to fix it. After the procedure was done, I had no pain at all — and 10 days later, I’m back to normal,” said Cynthia. “I knew I was in good hands with Dr. Wilderman, and I’m glad he was the one who performed my procedure. God bless Dr. Wilderman and his team.”

ABOUT HACKENSACK MERIDIAN HEALTH HACKENSACK UNIVERSITY MEDICAL CENTER

Hackensack University Medical Center, a 781-bed nonprofit teaching and research hospital, was Bergen County’s first hospital founded in 1888. It was also the first hospital in New Jersey and second in the nation to become a Magnet®-recognized hospital for nursing excellence, receiving its sixth consecutive designation from the American Nurses Credentialing Center. The academic flagship of the Hackensack Meridian Health network, Hackensack University Medical Center is Nationally-Ranked by US News & World Report 2022-2023 in four specialties, more than any other hospital in New Jersey. The hospital is home to the state’s only nationally-ranked Urology and Neurology & Neurosurgery programs, as well as the best Cardiology & Heart Surgery program. It also offers patients nationally-ranked Orthopedic care and one of the state’s premier Cancer Centers (John Theurer Cancer Center at Hackensack University Medical Center). Hackensack University Medical Center also ranked as High-Performing in conditions such as Acute Kidney Failure, Heart Attack (AMI), Heart Failure, Pneumonia, chronic obstructive pulmonary disease (COPD), Diabetes and Stroke. As well as High Performing in procedures like Aortic Valve Surgery, Heart Bypass Surgery (CABG), Colon Cancer Surgery, Lung Cancer Surgery, Prostate Cancer Surgery, Hip Replacement and Knee Replacement. This award-winning care is provided on a campus that is home to facilities such as the Heart & Vascular Hospital; and the Sarkis and Siran Gabrellian Women’s and Children’s Pavilion, which houses the Donna A. Sanzari Women’s Hospital and the Joseph M. Sanzari Children’s Hospital, ranked #1 in the state and top 20 in the Mid-Atlantic Region in the US News & World Report‘s 2022-23 Best Children’s Hospital Report. Additionally, the children’s nephrology program ranks in the top 50 in the United States. Hackensack University Medical Center is also home to the Deirdre Imus Environmental Health Center and is listed on the Green Guide’s list of Top 10 Green Hospitals in the US Our comprehensive clinical research portfolio includes studies focused on precision medicine, translational medicine, immunotherapy, cell therapy, and vaccine development. The hospital has embarked on the largest healthcare expansion project ever approved by the state: Construction of the Helena Theurer Pavilion, a 530,000-sq.-ft., nine-story building, which began in 2019. A $714.2 million endeavor, the pavilion is one of the largest healthcare capital projects in New Jersey and will house 24 state-of-the-art operating rooms with intraoperative MRI capability, 50 ICU beds, and 175 medical/surgical beds including a 50 room Musculoskeletal Institute.

ABOUT HACKENSACK MERIDIAN HEALTH

Hackensack Meridian Health is a leading not-for-profit health care organization that is the largest, most comprehensive and truly integrated health care network in New Jersey, offering a complete range of medical services, innovative research and life-enhancing care. The network has 18 hospitals and more than 500 patient care locations, which include ambulatory care centers, surgery centers, home health services, long-term care and assisted living communities, ambulance services, lifesaving air medical transportation, rehabilitation centers, urgent care centers, physician practice locations, and a fitness and wellness center. With more than 35,000 team members and 7,000 physicians, Hackensack Meridian Health is a distinguished leader in health care philanthropy and committed to the health and well-being of communities throughout New Jersey.

The network’s notable distinctions include having more US News-ranked hospitals than any other health system in New Jersey, nor ranked by US News & World Report, 2022-23. Hackensack University Medical Center is nationally ranked by US News & World Report in four specialties, more than any other hospital in New Jersey. Joseph M. Sanzari Children’s Hospital at Hackensack University Medical Center, and K. Hovnanian Children’s Hospital at Jersey Shore University Medical Center, are ranked #1 in the state and top 20 in the Mid-Atlantic Region by US News & World Report‘s 2022-23 Best Children’s Hospital Report. Additionally, their combined nephrology program ranks in the top 50 in the United States. To learn more, visit www.hackensackmeridianhealth.org.

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