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Home is where the heart care is
Plainview Hospital's new cardiac cath lab made it easy for a retired teacher — and photography enthusiast — to get the care he needed
Peter Accardi had felt this way before. While on a stroll through the town of Lake George during a family getaway last spring, the 63-year-old retired teacher suddenly had to stop. “I had pressure in my chest and was short of breath,” he recalls. He told his family he needed to rest. But he knew something might be wrong with his heart — again.
Five years earlier, similar symptoms revealed that a near-complete blockage in a major coronary artery was drastically reducing blood flow through his heart. The father of three was on the verge of a heart attack, emergency department physicians at Plainview Hospital told him. They sent him by ambulance to the Sandra Atlas Bass Heart Hospital at North Shore University Hospital in Manhasset for an angioplasty and stent — a procedure in which a long, thin catheter with a balloon at its tip is used to widen the clogged artery, and then a tiny mesh tube, or stent, is placed to help keep it open.
Resting on a bench, Accardi began to feel better, but as soon as the family returned home to Hicksville, he went to see his cardiologist, Sandy Kahn, MD. His intuition was correct: Something was wrong with his heart. But this time, he would not have to travel for treatment. A state-of-the-art cardiac suite had just opened at Plainview Hospital, and Accardi would become one of its first patients.
Complex care, just around the corner
In June, Plainview Hospital unveiled a new cardiac catheterization laboratory, created with a single goal: to provide 24/7 access to lifesaving care for patients at the hospital and in surrounding communities.
“Before the lab opened, patients who presented with cardiac emergencies, like a heart attack, would need to be quickly transferred to another Northwell hospital for treatment,” says Loukas Boutis, MD, chair of cardiology at Plainview Hospital and director of the new lab. “Now, we can open blockages and treat heart attacks within minutes. Time saved is heart muscle saved, which means lives saved.”
In addition to procedures like angioplasty and stenting, interventional cardiologists at the lab can also perform tests to assess heart failure treatments. Having a local hospital that can offer these advanced cardiac services is invaluable to patients, adds Dr. Boutis.
The timing of the lab’s launch proved perfect for Accardi. When a stress test suggested his heart might not be getting enough blood, Dr. Kahn referred Accardi to his colleague Dr. Boutis for more specialized testing. The cardiac catheterization lab had opened just three days prior.
In-stent restenosis prompts on-the-spot treatment
On June 9, Accardi had a coronary angiogram. First, Dr. Boutis inserted a catheter into a blood vessel in Accardi’s arm and threaded it up to his coronary artery. He injected a type of dye that’s visible on X-ray images through the catheter and took a series of scans to check blood flow. Accardi also suffers from diabetes and chronic kidney disease, so too much dye could pose risks — but the new lab’s intravascular ultrasound (IVUS) provided a safeguard. “With this advanced technology, we only needed to use a fraction of the usual amount of contrast dye, helping protect his kidneys,” says Dr. Boutis.
The angiogram revealed Accardi had something called in-stent restenosis: The coronary artery had narrowed again, right at the spot where he had the stent. That problem can be due to scar tissue underneath the stent, explains Dr. Boutis. In-stent restenosis can also occur in patients with diabetes (like Accardi), kidney disease or high cholesterol, who are at an increased risk for plaque buildup in the arteries.
To re-open the narrowed artery, Accardi would need another stent placed inside the first one — a stent-in-stent procedure Dr. Boutis performed right then and there. With another catheter, he threaded a new stent up to the blocked section of the coronary artery. Inflating the catheter’s balloon, he expanded the stent — pushing the first stent and any plaque aside so blood could again flow freely.
Accardi spent a night at the hospital so doctors could monitor his heart and kidney function, and then headed home. “It’s reassuring to have this advanced level of care, right in my own community,” he says.
Living life to the fullest
Just six weeks after his procedure, Accardi and his family enjoyed a cruise to Halifax, Nova Scotia. “I took the stairs instead of the elevator and walked around the seaport without having to find benches to rest,” he says.
Today, Accardi spends his time with his wife and three children and indulging his love for photography. He works part-time for a local studio, snapping shots of high school events and sports teams, as well as occasional parties. Even in his off hours, he makes time to capture the beauty of nature around him. “I’m grateful for my second chance,” he says. “I plan to enjoy every second.”
The cath lab facility joins Northwell's expansive cardiology services.
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Inside Plainview’s new cardiac cath lab
The 8,100-square-foot cardiac catheterization lab offers two procedure rooms, 10 patient recovery beds and four dedicated intensive care unit (ICU) beds — prepped and ready to serve 24 hours a day, seven days a week. “It is changing the lives of patients in our community,” says Michael Fener, executive director of Plainview and Syosset Hospitals. “We can lessen the severity of heart attacks and provide immediate cardiac care right in their own backyard.”
Treatments offered at the lab include:
Diagnostic catheterization. These tests assess heart muscle function and measure pressure in areas of the heart to help cardiologists develop heart failure treatment plans or evaluate how well they are working.
Implantation of a remote monitoring system for your heart. The CardioMEMS™ device is implanted through a catheter into the pulmonary (lung) artery, where it measures changes in pressure. That helps cardiologists keep a close eye on a patient’s heart failure.
Minimally invasive vascular procedures. When arteries that supply blood to arms and legs narrow, it can lead to severe, painful cramps. With these procedures, doctors can help widen those vessels, as well as remove dangerous blood clots that can develop in deep veins (a problem called deep vein thrombosis).
In 2024, a new electrophysiology lab will open next to the cath lab to diagnose and treat patients experiencing heart rhythm problems, such as atrial fibrillation. Doctors will be able to implant pacemakers and perform cardiac ablations, among other procedures. One thing that remains the same: Patients still have access to all the resources of Northwell Health. Those who need cardiac surgery or further treatment and management will be transferred to Northwell’s Sandra Atlas Bass Heart Hospital at North Shore University Hospital in Manhasset.
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