Catheter Ablation Procedure: What you need to know

Submitted by emily.griffin on

Catheter ablation is a minimally invasive procedure to treat atrial fibrillation (AFib).

1. What is AFIB?

It is a common type of heart arrhythmia that causes the heart to beat irregularly. It occurs when the upper chambers of the heart no longer contract in coordination.

2. What are the symptoms?

This can occur without symptoms or may make you feel tired, lightheaded, short of breath or a fluttering sensation in your chest.

3. Is AFib dangerous?

When your heart beats irregularly with AFib, it can lead to blood clots, especially in the left atrial appendage (LAA) of the heart. In this scenario, you are five times more likely to have a stroke than someone with a regular heartbeat. Although blood thinners can reduce your risk of stroke, medications create other dangers, including bleeding.

4. Are patients awake during the procedure?

Patients receive medication to help them relax. A local anesthetic will numb the site where the catheter is inserted. Occasional general anesthesia is used.

5. How is a catheter ablation performed?

Thin, flexible tubes called catheters are inserted into a vein in the groin and move into the heart. There is an electrode at the tip of each catheter. The electrode sends radio waves that create heat. The heat is delivered to the heart tissues that causes AFib. You can watch a video explaining the procedure by clicking here.

6. How long is the patient in the hospital?

If performed as an outpatient you may go home the same day or be discharged the next day.

7. Who performs the procedure? 

The EP team.

Make an appointment

Talk to your doctor to determine if catheter ablation is right for you.

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Genesis is one of America’s Top 50 Heart Hospitals

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Catheter Ablation Procedure: What you need to know

Catheter ablation is a minimally invasive procedure to treat atrial fibrillation (AFib).

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Genesis vascular surgeons save lives through stroke prevention with TCAR procedure

Submitted by Kyle.Norton on

Did you know stroke is the fifth leading cause of death and a leading cause of disability in the U.S.? Just as these facts may be surprising, the reality is even more shocking for those told they’re at high risk of the disease. Known as a “brain attack,” symptoms of a stroke are often silent until it causes devastating temporary or permanent disabilities, or worse, is fatal.

Fortunately, vascular surgeons at Genesis HealthCare System proactively monitor patients at high risk of stroke and provide cutting-edge preventative management with the minimally invasive procedure Transcarotid Artery Revascularization (TCAR).

“TCAR is a very welcome treatment for patients in the high-risk category,” explained Michael J. Kunstmann, D.O., fellowship-trained and board-certified vascular surgeon, Genesis Heart & Vascular Institute. “The recovery time is less, the incision is smaller and the stroke rate is less than the standard treatment of carotid endarterectomy (CEA).”

Michael J. Kunstmann, D.O.

TCAR: Expanding stroke prevention care

For many, the risk of stroke increases due to blockage of a carotid artery. As the two main arteries that carry oxygen-rich blood from the heart to the brain, a blocked carotid artery often goes undetected until symptoms surprise a stroke victim, including:

- Sudden loss of vision, blurred vision or difficulty seeing out of one or both eyes

- Weakness, tingling and numbness on one side of the face, one side of the body or in one arm or leg

- Sudden difficulty in walking, loss of balance or lack of coordination

For some, a blocked carotid artery may be discovered during treatments for other chronic conditions. Regardless of how it’s found, treatment decisions are an immediate concern.

“The TCAR procedure is particularly well-suited for patients with other current or previous health issues,” Dr. Kunstmann noted. “We look at people who have had previous neck surgery or radiation, or those who have had previous endarterectomies as good candidates for the procedure. We also look at patients who are older and won’t necessarily tolerate carotid endarterectomy due to it being a longer procedure using a longer incision.”

A surgical procedure performed under local or general anesthesia, TCAR is completed through a small incision at the neckline just above the clavicle. After placing a tube directly into your carotid artery, the surgeon connects it to a system that directs blood flow away from your brain to prevent any loose plaque from reaching the brain. After being filtered, your blood will return through a second tube. A carotid stent is then placed to stabilize the plaque in your carotid arteries, and blood flow resumes its normal direction.

Take advantage of preserving life’s precious time

TCAR is a preventive treatment to avoid a stroke. Several factors are considered before recommending the procedure. “One factor we consider is if you have an 80% blockage, then your risk of stroke is approaching 10% a year,” said Lane Lee, D.O., fellowship-trained and board-certified vascular surgeon. “Your risk of a stroke with TCAR is generally much less than 2%.”

Dr. Lee stressed the importance and benefits of stroke prevention. “If you’ve had a stroke, there’s not much I can do to help. However, the TCAR procedure can prevent a stroke.”

The Food and Drug Administration (FDA) approved the TCAR procedure in 2015. At that time, fewer than 20 institutions were using the procedure; by 2019, the number had grown to over 200 institutions. The expansion of the use of TCAR is fueled by the extensive data on procedure outcomes being recorded by the Vascular Quality Initiative. All physicians in the U.S. performing TCAR have to be enrolled in the databank and record the outcomes of every procedure.

“All TCAR data is in the databank, from beginners to experts,” said Dr. Lee. “It’s not just the 10 best guys who know how to do this, it’s everybody. When you look at the overall databank, the stroke rate is less than 2% for this procedure.”

Genesis HealthCare System continues to have great success performing TCAR, and offering this innovative procedure is an important addition to patient care. “It definitely aids us by being able to provide our patients the best vascular care locally,” said Dr. Kunstmann.

Lane Lee, D.O.

 

Contact the Genesis Heart & Vascular Institute

If you or someone you are caring for have been recently diagnosed with carotid artery blockage, contact the Genesis Heart & Vascular Institute to learn more and to see if the TCAR procedure is appropriate.

How & Why Stroke Occurs

A stroke is caused when a blood vessel carrying oxygen and nutrients to the brain is either blocked by a clot (an ischemic stroke), or bursts or ruptures, preventing blood flow to the brain (known as a hemorrhagic stroke). A “mini-stroke,” or TIA (transient ischemic attack), is caused by a temporary clot. All three types of stroke cause brain cells to begin dying within minutes.

Some risk factors of stroke can’t be controlled, including:

· Age

· Heredity (family history) and race

· Gender

· Prior stroke or heart attack

Risk factors you can control to reduce your risk of stroke include:

· High blood pressure

· Cigarette smoking

· Diabetes

· Carotid or other artery disease

· Atrial fibrillation

· Other heart disease

· Sickle cell disease (also called sickle cell anemia)

· High blood cholesterol

· Poor diet

· Physical inactivity and obesity

Supporting HealthCare in Our Communities

The Genesis HealthCare Foundation is here to promote charitable support for Genesis HealthCare System. Find more ways you can help.

Minimally invasive procedure takes advantage of every second to reduce and proactively manage stroke risk.

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Transcarotid Artery Revascularization

Submitted by Jeff.Mills on

Watch Dr. Kunstmann Talk About the Transcarotid Artery Revascularization Procedure

Transcarotid Artery Revascularization (TCAR)

TCAR is a less-invasive method for reducing the risk of stroke and complications while treating carotid artery disease in one or both neck arteries. During the procedure, a small incision is made in the neck. A tube is inserted into the carotid artery and connected to equipment to direct blood flow away from the brain temporarily. The blood is filtered before returning to a vein in the groin. In addition to fewer risks during the TCAR procedure, a smaller incision is used to reduce scarring and procedure time is less than half compared to carotid endarterectomy. Most patients return home the day after the procedure

Top 50 heart hospital

Genesis is one of America’s Top 50 Heart Hospitals

For the 2nd year in a row

Transcarotid Artery Revascularization (TCAR)

TCAR is a less-invasive method for reducing the risk of stroke and complications while treating carotid artery disease in one or both neck arteries. 

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Heart Pillows: Pressure Can Reduce Pain for Cardiac Patients

Submitted by Jeff.Mills on

Sneezing, coughing, movement are more manageable for patients

Open heart surgery—a serious but highly successful operation—can make everyday actions like coughing, deep breathing, sneezing, laughing, getting out of bed and even the hiccups uncomfortable for patients right after surgery. Open heart surgeries require dividing the sternum (chest cavity) to allow access to the heart, so the breastbone and chest area need extra support for up to three months following the procedure.

One of the ways patients have been able to reduce their discomfort after open heart surgery is with the use of a heart-shaped pillow—filled with firm stuffing, that can help provide comfort, reduce pain and protect the surgery’s incision site.

But how can a non-medicated pillow help with pain?

Heart pillows can help reduce pain after surgery

Because of the increased risk of pneumonia and respiratory issues after surgery, patients are asked to cough and breathe deeply frequently so their lung fully expand and to get rid of phlegm. As part of the recovery process, patients also breathe into a device called an incentive spirometer multiple times a day for the first month to keep their lungs healthy after surgery.

Having a heart-to-heart hug with these pillows can lessen pain and makes movement more manageable for patients who’ve recently undergone coronary artery bypass grafting, valve repair or valve replacement. Clasping the heart pillow offsets the pain and safeguards the incision site.

“Patients embrace the heart pillow whenever they need to brace themselves for movement that might cause pain or injury to the incision site. If your pain is well managed, the more you will be able complete breathing exercises and walking that are important to your recovery,” says cardiothoracic vascular surgeon Philip Bongiorno, MD.

Pressure helps protects the incision site

After open heart surgery, incision care is extremely important. Patients are instructed to avoid lifting anything that weighs more than 10 pounds, but research has found that a cough pushes about 60 pounds of pressure against the sternum, while a sneeze places 90 pounds of pressure in the same area.

Bursts of pressure that powerful might break internal wires from surgery that hold the breastbone together. If one of these vital wires breaks, the only way to fix it is undergoing another surgery.

When a patient holds the heart pillow tightly against his or her chest, the pillow provides an extra layer of pressure to counteract any jolting from a cough, sneeze or movement. It helps reduce pain because it holds the incision and sensitive skin surrounding the incision firmly in place.

So what’s in a pillow anyway?

Filled with firm stuffing, so a squeeze won’t squish them flat like a child’s stuffed animal, the red heart pillows measure about 18 inches wide and 12 inches tall. Each pillow features a printed diagram of the anatomy of the heart, which comes in handy during conversations when patients explain their procedure to friends and family. Genesis staff members often autograph the pillows and write well wishes to the patient making it a huggable memory book too.

Originally, Genesis handed out large teddy bears for the same purpose. The bear, nicknamed “Sir Coughs-A-Lot,” was replaced by the heart pillow in 2013, because the wide shape of the heart provides better chest coverage. Plus, patients report having an easier time using the heart-shaped pillow effectively.

Patients use tightly folded blankets in the hospital

Upon leaving Genesis Hospital, open-heart surgery patients often clutch heart-shaped pillows to their chest. Genesis nurses present the pillow to the patient when it’s time to leave the hospital and complete recovery at home. Waiting until the time of departure ensures that the pillow remains sanitary for the patient.

While recovering in the hospital, patients use tightly folded blankets to provide similar sternum support, gripping the folded blanket to buffer pressure, pain and pulling, and to protect against repeat surgeries.

The heart pillows have become a prized possession to many Genesis cardiac patients. Patients often regard these pillows as a trophy – they represent surviving a traumatic and life-saving surgery. Most patients express tremendous gratitude for the procedure, and for the pillow too.

Heart pillows for electrophysiology and cardiac cath lab patients

Patients who undergo procedures that open the sternum, like coronary artery bypass grafting, valve repair or valve replacement surgery, receive the larger, firm heart-shaped pillows, but Genesis cardiac patients with different types of procedures receive a different type of heart pillow.

A generous group of Genesis volunteers sews and donates smaller, softer heart-shaped pillows for patients who experience procedures in the Cath Lab or Electrophysiology Lab. These colorful pillows can come in solid colors or wild prints and patterns. The volunteers happily use whatever type of fabric they can find. These heart pillows prop up patients, provide comfort and offer a personal touch.

Each year, an average of 3,500 heart pillows go home with Genesis cardiac patients including the firm postoperative pillows and the soft ones made by volunteers. For cardiac patients, Genesis heart pillows offer a huggable memento that lasts long after scars heal.

Heart Pillows for Cardiac Patients

Heart patients reduce their discomfort after open heart surgery with the use of a post-operative heart-shaped pillow at Genesis HealthCare in Zanesville, Ohio.

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The WATCHMAN™ Implant: What You Need to Know

Submitted by Anonymous (not verified) on

 

The WATCHMAN™ Implant: 10 Questions Answered

The WATCHMAN Implant can reduce your risk of stroke and eliminate your use of blood thinners if you have atrial fibrillation (AFib) not caused by a heart valve problem.

1. What is AFib?

It is a common type of heart arrhythmia that causes the heart to beat irregularly. It occurs when upper chambers of the heart (right and left atria) no longer contract in coordination.

2. What are the symptoms?

This can occur without symptoms or may make you feel tired, lightheaded, short of breath or a fluttering sensation in your chest.

3. Is AFib dangerous?

When your heart beats irregularly with AFib, it can lead to blood clots, especially in the left atrial appendage (LAA) of the heart. In this scenario, you are five times more likely to have a stroke than someone with a regular heartbeat. Although blood thinners can reduce your risk of stroke, medications create other dangers, including bleeding. Other factors that increase stroke risk include ages 75 and up, high blood pressure, heart failure, diabetes, cardiovascular disease and prior stroke.

4. How does WATCHMAN help?

The WATCHMAN Implant prevents blood clots in the LAA by closing it. The LAA is where 90% of stroke-causing blood clots come from in the heart.

5. Is WATCHMAN safe?

Over 100,000 people worldwide have received the WATCHMAN Implant. It is the only implant of its kind approved by the FDA. With all medical procedures, there are risks associated with the implant procedure and the use of the device. Talk to your doctor, so you thoroughly understand all of the risks and benefits associated with the WATCHMAN Implant.

6. What are typical results?

You may be able to stop using blood thinners 45 days after your implant. After one year, 99% of patients discontinued using blood thinners.

7. What happens during the procedure?

During this one-time, minimally invasive procedure, a narrow tube is inserted into a blood vessel in your upper leg and goes to your LAA. The WATCHMAN is inserted through the tube until it reaches the LAA, where it unfolds like an umbrella. A thin layer of tissue will grow over the surface of the implant within about 45 days.

General anesthesia is used, so you are asleep during the procedure.

8. How long will I be in the hospital?

You will likely return home the day after the procedure.

9. What happens after the procedure?

Your follow-up appointment will be approximately 45 days after your procedure. At this time, your physician will check if tissue has adequately covered the WATCHMAN Implant. If so, you may be able to stop taking blood thinners. If not, you will have a follow-up appointment scheduled as necessary to monitor the progress.

10. Who performs the procedure?

Trained and experienced physicians, Kinan Kassar, M.D., interventional cardiologist, and Shaun Bhatty, M.D., electrophysiologist, who are both part of the Genesis Heart & Vascular Group.

Make an appointment

Talk to your doctor to determine if the WATCHMAN Implant is right for you.

 

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Genesis is one of America’s Top 50 Heart Hospitals

For the 2nd year in a row

The WATCHMAN™ Implant
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Skin Smarts: How to Take Care of Your Skin as You Age (Infographic)

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No sunscreen protects you completely

Your skin. We often call it (affectionately, of course) your birthday suit. It’s your body’s largest organ, weighing in at roughly eight pounds and covering about 22 square feet. 

Many skin changes are just a normal part of the aging process. However, others can signal health problems. It pays to know what is normal and what is not.

Learn what you can do to protect your skin as you age--be kind, be gentle and be aware.

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Monarch Robotic-assisted Bronchoscopy

Submitted by Anonymous (not verified) on

Lung cancer is the leading cause of cancer deaths worldwide. The disease hides in the lungs and usually does not show symptoms until it is too late. That changes now.

Watch Dr. Adamo Explain the Monarch Robotic-assisted Bronchoscopy System


 

Diagnosing lung cancer earlier and more accurately saves lives

Listen to Emily Brawner describe the Monarch Robotic-assisted Bronchoscopy System on the Sounds of Good Health with Genesis Podcast

As part of our commitment to provide the best care, we have invested in innovative technology to overcome the traits that make lung cancer so deadly.

The revolutionary Monarch Robotic-assisted Bronchoscopy has a flexible tube, 3D camera and precision control. With Monarch, our doctors can search for cancer in a maze of passageways. When something suspicious is located, they can take biopsies that were previously unreachable without surgery. The results are earlier and more accurate diagnosis than ever before.

Additionally, since it is minimally invasive, patients go home the same day of the procedure.

Patient Shelly

"When I learned about that spot on my lung, I felt devastated. I wanted the best and quickest help I could get, and that’s what I received at Genesis,” Shelly said.

To learn what the biopsy revealed, and how Genesis provided Shelly with the highest of quality care, click here.

Comprehensive Care

The Monarch Robotic-assisted Bronchoscopy is one of the many resources we use to keep you healthy. Along with the latest technology and our low dose CT screening program, our pulmonary doctors partner with specialists to ensure you receive the best treatment for your specific situation now and in the future.

James Adamo, M.D., F.C.C.P and Emily Brawner, D.O., F.C.C.P. are our trained and experienced physicians who perform the Monarch Robotic-assisted bronchoscopy.

Call 740-586-6888 to learn more and find out if the Monarch procedure is appropriate for you.

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MitraClip™ Implant: What You Need to Know

Submitted by Anonymous (not verified) on

MitraClip™ Implant Questions and Answers

1. What is mitral valve regurgitation?

a. This occurs when the mitral valve flap in your heart does not work correctly, allowing blood to leak backwards into the heart.

2. Are there symptoms?

a. You may be symptom free, or suffer from one or more of the following including a mild cough, lightheadedness, fatigue, shortness of breath that increases with activity and lying down or rapid heartbeat.

3. Is mitral valve regurgitation dangerous?

a. There are two forms of mitral valve regurgitation. Degenerative mitral regurgitation is when a valve is damaged. The damage can be from a birth defect, certain infections or aging. Degenerative mitral regurgitation can lead to strokes.

4. Who are candidates for MitraClip?

a. MitraClip can help, if you have degenerative mitral regurgitation and are considered high risk for surgery. MitraClip is a solution for functional mitral disease if treatments did not help.

5. What happens during the procedure?

a. The MitraClip implant is a one time, minimally invasive procedure. The implant is inserted through a vein in your upper leg and guided to your heart, where it is attached to your mitral valve.

General anesthesia is used so you will be asleep during the procedure.

6. How does MitraClip help?

a. After the MitraClip is attached to the malfunctioning mitral valve in your heart, it will help the valve to close properly and restore normal blood flow through the heart.

7. What happens after the procedure?

a. You will stay in the hospital for one to three days. After the implant, you will take a blood thinner and aspirin. A checkup will occur in 30 days and at one year.

8. Who is on the procedure team?

a. A trained and experienced team of physicians make up the MitraClip team. The team includes Kinan Kassar, M.D., Interventional Cardiologist, Mahmoud Farhoud, M.D., Cardiologist Imaging Specialist and Selomie Kebede, M.D., Cardiologist Imaging Specialist. Each of these physicians are part of the Genesis Heart & Vascular Group.

 

 

 

 

 

 

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Genesis is one of America’s Top 50 Heart Hospitals

For the 2nd year in a row

Mitra Clip

MitraClip™ Implant Questions and Answers

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Advanced Minimally Invasive Treatments Tackle Structural Heart Disease

Submitted by Anonymous (not verified) on

It's been said "it always seems impossible until it's done." This statement couldn't be truer for the advanced minimally invasive treatments used today for structural heart disease. As one of the most exciting and fastest growing fields in cardiovascular medicine, technological developments over the last decade have led to previously unthinkable procedures becoming a successful option for a wide range of patients with defects or disorders in their heart's structure.

Not all heart disease is the same

Eating healthy and exercising is important for preventing coronary heart disease, which is caused by plaque buildup in the arteries that can cause chest pain and even heart attack. But, structural heart disease is different.

A heart problem that is structural may be present at birth (congenital) causing conditions such as a hole within the chambers of the heart. Structural heart disease acquired through wear and tear due to aging and time can lead to a tight aortic valve (aortic stenosis), or a leaky heart valve (mitral valve regurgitation) causing some blood to leak backward through the valve.

For patients with severe aortic stenosis, or narrowing of the aortic valve, the only treatment option for the last 50 years has been open heart surgery. While open heart surgery may still be a solution for some patients, minimally invasive catheter-based therapies have made care easier, with fewer complications and quicker recoveries.

Minimally invasive evolution: TAVR

As the most common structural heart disease treated today, heart valve disease is being successfully managed with non-surgical minimally invasive procedures, including transcatheter aortic valve replacement (TAVR). An increasingly-popular alternative to surgical repair, TAVR is a proven alternative to more traditional aortic valve surgery for both the medium or high-risk patient, and has more recently expanded as an option for those at lower risk. In fact, statistics from the Society of Thoracic Surgeons reports the number of U.S. TAVR procedures has risen from less than 5,000 in 2012 to more than 50,000 in 2018.

TAVR is a complete paradigm shift. Often completed through a tiny nick in the groin or a small cut in the neck, TAVR is performed by using a tube called a catheter and tools that fit inside the catheter. By putting the catheter into a blood vessel, we move it through the blood vessel into the heart.

The catheter holds a new artificial valve, which is then implanted or deployed into the damaged aortic valve. As the artificial valve expands it takes the place of the damaged valve. The TAVR procedure repairs the heart valve without removing the damaged valve.

After an average one or two day stay in the hospital, TAVR patients can resume normal activities within a week following the procedure. TAVR was initially approved for high-risk patients in poor health who weren't considered good candidates for traditional open-heart surgery. Now, essentially anyone who has symptomatic aortic valve stenosis is a candidate for TAVR.

Signs it's time to take steps for healing

While some people with aortic valve stenosis may not experience symptoms for many years, the disease has typically progressed to an advanced stage by the time mild to severe symptoms are noticed. A wide range of warning signs that may indicate severe narrowing of the valve and treatment is necessary, include:

  • Abnormal heart sound (heart murmur) heard through a stethoscope
  • Chest pain (angina) or tightness with activity
  • Feeling faint or dizzy or fainting with activity
  • Shortness of breath, especially when after being active
  • Fatigue, especially during times of increased activity
  • Heart palpitations (sensations of a rapid, fluttering heartbeat)

Aortic valve stenosis may also lead to heart failure, with signs and symptoms of heart failure include fatigue, shortness of breath and swollen ankles and feet.

Studies show that 50% of patients who don't receive a valve replacement are unlikely to survive more than an average of two years after symptoms begin,. While the procedure isn't without its risks, including bleeding problems and stroke, any patient who has severe aortic stenosis should be considered for TAVR.

Ready to take the next step in your journey?

Make an appointment to see how Genesis HealthCare System can help

Beyond TAVR: MitraClip

As TAVR evolves for treatment of aortic valve narrowing, technology is addressing another form of structural heart disease: mitral regurgitation or leaky heart valve. Known as the MitraClip™, the innovative transcatheter device has been used since 2013 to provide relief of leaky heart valve without the risk of conventional surgery.

Five years later, research showed transcatheter mitral valve repair with the MitraClip significantly reduces hospitalization and all-cause mortality compared with medical therapy alone. In patients with heart failure and moderate-to-severe or severe mitral regurgitation who continue to have symptoms despite optimal medical therapy, MitraClip is a successful treatment option. In addition, the FDA's broadened approval of the device supports MitraClip as an option for a broad range of patients with mitral regurgitation.

People who have abnormalities of the mitral valve can develop heart failure symptoms such as shortness of breath, fatigue and swelling in the legs — signs the valve is leaking severely.

A minimally invasive catheter-based procedure, MitraClip treats a severely leaking mitral valve by inserting the implant through a catheter inserted in a vein in the upper leg and guided to the heart. Once the implant (a clip) is attached to the mitral valve it can then close properly to restore normal blood flow.

Top 50 heart hospital

Genesis is one of America’s Top 50 Heart Hospitals

For the 2nd year in a row

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